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Patient Education - Hyperbaric Oxygen Therapy for Osteoradionecrosis

Patient Education - Hyperbaric Oxygen Therapy for Osteoradionecrosis

Patient Education - Hyperbaric Oxygen Therapy for Osteoradionecrosis

What is Hyperbaric Oxygen Therapy (HBOT)?

Hyperbaric oxygen therapy (HBOT) is a medical treatment in which the patient breathes pure oxygen under pressure. It is administered in a chamber and is the treatment for many medical and surgical conditions. It is usually part of an overall plan of care which may involve surgery, antibiotics or other therapy, but for certain conditions it may be the main treatment.

How does HBOT work?

During hyperbaric oxygen therapy, 100% oxygen is delivered in a closed chamber, and air pressure is increased to as much as 3 times normal. This causes a dramatic increase in oxygen taken in by the lungs which is then transferred to the blood. The blood then transports the oxygen to all parts of the body. The oxygen-rich blood helps improve healing and controls infection in certain conditions.

How does HBOT help heal my osteoradionecrosis of the mandible (ORN)?

Osteoradionecrosis (ORN) of the mandible occurs when the jaw bone of the mouth becomes damaged due to radiation. Radiation treatment for cancer targets and destroys cancer cells but can also injure healthy tissue including bone near the cancer. ORN can occur just after radiation has ended or it may appear years later.

All bones need a constant supply of blood to stay alive. Oxygen and nutrients in the blood keep bones healthy and are delivered by blood vessels, called arteries, to the bone. Radiation can damage arteries within bones by causing scarring and narrowing. This narrowing creates low blood flow and reduces oxygen delivery to the bone. Without this oxygen-rich blood, bones cannot survive.

Hyperbaric oxygen therapy has been proven to be beneficial with this condition by delivering more oxygen to the damaged bone. HBOT also assists with healing by:
  • Reducing scarring within blood vessels
  • Stimulating new blood vessel growth
  • Preventing poor healing at surgery sites in areas that have received radiation
Figure 1. Effects of hyperbaric oxygen therapy on osteoradionecrosis of the mandible. Picture by Worth E, M.D.

What should I expect with HBOT for my ORN?

  • The complexity of bone damage determines the total number of hyperbaric treatments.
  • Treatments are scheduled daily, and the total number of treatments ranges from 40 to 60.
  • Initially, you will undergo 30 treatments with HBOT.  After 30 treatments, you will be evaluated by your oral surgeon to determine if surgical removal of the damaged bone is needed.
  • After surgery, 10 or more additional HBOT treatments may be recommended.
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NOTE: This is a controlled document. This document is not a substitute for proper training, experience, and exercising of professional judgment. While every effort has been made to ensure the accuracy of the contents, neither the authors nor the Wound Reference, Inc. give any guarantee as to the accuracy of the information contained in them nor accept any liability, with respect to loss, damage, injury or expense arising from any such errors or omissions in the contents of the work.
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