A Retrospective Study of Outcomes in Subjects of Head and Neck Cancer Treated with Hyperbaric Oxygen Therapy for Radiation Induced Osteoradionecrosis of Mandible at a Tertiary Care Centre: An Indian Experience

Abstract

Osteoradionecrosis (ORN) of the mandible is a rare complication of radiation therapy for head and neck cancer. It manifests as an area of exposed necrotic bone failing to heal for at least 3months. Our study aims to determine the effectiveness of HBO in management of radiation induced mandibular ORN. A retrospective study of 33 subjects of mandibular ORN treated with HBOT during period 2009-2011 was carried out. The mean patient age was 60years (range 41-80).They were treated in a multiplace hyperbaric chamber at 2.4 ATA, for 90min once a day for up to 30 sessions. Pre and post treatment improvement in relation to symptoms, healing of intraoral wound and overall wellbeing were evaluated. Out of 33 Subjects, 48% (n=16) cases showed complete healing of wound, 18% (n=6) had marked healing, slight healing in 24% (n=8) cases and 9% (n=3) cases had no change in healing. 70% (23 of 33) cases had significant reduction in pain, 62% (18 of 29) cases had improved jaw opening, 41% (11 of 27) cases and 71% (20 of 28) cases showed improvement in ability to talk and mouth dryness respectively. Overall 85% (28 of 30) cases showed improvement. Our clinical experience supports the efficacy of HBO treatment for radiation induced mandibular ORN and we recommend additional multicentric, prospective studies to be carried out defining the role of HBOT using at least 30 sessions in such cases.