Mandibular Osteoradionecrosis is a late complication of radiation therapy for cancers of the head and neck, particularly of the oral cavity. Mandibular Osteoradionecrosis is also the most frequently reported radiation injury. This high frequency is because of the singularity of the blood supply running through the matrix of the bone and the proximity of the tumor to the mandible. Radiation decreases the number of osteoclasts and osteoblasts in the irradiated mandible, and if the mandible is fractured the healing is further delayed.
Hyperbaric Oxygen Therapy (HBOT) has an important role in the management of Osteoradionecrosis of the mandible.
The Marx/University of Miami protocol consists of 3 stages.
Below, please find the accepted protocol for your Osteoradionecrosis patients.
Daily HBOT treatments at 2.0-2.4 ATA (90 min), for 20 days, wound care, no bone removal and discontinuance of antibiotics. If improvement continuous, ten further sessions of HBOT are given.
Daily HBOT treatments at 2.0-2.4 ATA (90 min), for 20 days. A local wound debridement is attempted to identify patients with only cortical bone involvement who do not require jaw resection. A transoral alveolar sequestrectomy is performed. If the healing continues satisfactorily, ten further HBOT are given. If the wound dehisces, the patient is considered to be a non-responder in stage 2 and is moved to stage 3.
The patient is given 30 HBOT treatments followed by transoral partial jaw resection and a stabilizing procedure. A further 10 HBOT treatments are given.
The SOUTH FLORIDA CENTER FOR H.O.P.E. is a free standing, medically supervised, Medicare accredited, Hyperbaric Oxygen Therapy facility that has been serving the Tri-county area for the past 10 years