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HBO and Head & Neck Cancers

Prevention of Osteoradionecrosis (ORN) – bone death caused by radiotherapy

The lower jaw, the mandible, might receive radiotherapy during treatment for cancers such as cancer of the tongue, tonsil, palate or mouth. After radiotherapy, saliva production is often reduced. This has an adverse impact on dental health. Dentists usually refer people needing a tooth removed in an area which has previously received radiotherapy to a Maxillofacial surgeon. This is because dental procedures may precipitate deterioration in the bone to the point that part of the bone may not heal and even die. If this occurs more extensive surgery may be required to remove the dead bone.

Hyperbaric oxygen (HBO) before and after dental work has been recognised to help prevent this bone death in people who have had radiotherapy. A common course of treatment in this instance would be 20 once daily HBO, 5 days per week before dental work, 10 HBO sessions afterwards.

Treatment of Osteoradionecrosis (ORN) – bone death caused by radiotherapy

When bone death has occurred, the bone usually needs to be removed. Ostoeradionecrosis (ORN) can even cause bone to spontaneously fracture as it loses its strength. This can involve major surgery if reconstruction is needed. 

HBO can help areas of bone not yet dead but affected by the radiotherapy. This not only can help prevent further bone death, but can help make it more obvious during surgery which tissue is likely to survive and which needs removal. Thirty sessions of HBO before surgery and ten afterwards are usually recommended. 

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