Hyperbaric
oxygen may improve healing following surgical treatment for osteoradionecrosis
of the mandible.
Clinical Bottom Line:
1.
No quantifiable evidence of improvement in osteoradionecrosis after the
addition of hyperbaric oxygen to the treatment protocol.
Appraised
by: Mike Bennett, Dept of Diving and
Hyperbaric Medicine, Prince of Wales Hospital
Sydney; Friday, 11 June 1999
Clinical
Scenario: A patient with
osteoradionecrosis of the mandible presented for surgical debridement.
Three-part
Question: In patients with established
osteoradionecrosis, does the addition of hyperbaric oxygen to antibiotic and
surgical measures to the treatment protocol result in improved resolution of the
necrosis and improved wound healing?
Search
Terms: osteoradionecrosis
The
Study:
Double-blinded concealed
randomised controlled trial intention-to-treat unknown.
Patients with osteoradionecrosis
of the mandible. No further details.
Control group (N = 6; 0 analysed):
Usual treatment protocol involving antibiotics, analgesics, wound irrigation,
teeth extraction and sequestrectomies, plus 100% oxygen at 1.2ATA for 2 hours
daily, five days each week for eight weeks.
Experimental group (N = 6; 0
analysed): As above, but 100% oxygen exposure was at 2.0ATA on the same schedule
The
Evidence:
"Healing
process was better according to x-ray interpretation, clinical signs and
symptoms, and soft tissue lesions."
Comments:
1. No statistical analysis of
outcomes. The analysis was heralded but does not appear to have been published.
2. Small study would have low
power.
Expiry date: April 2003
References:
1. Tobey RE, Kelly JF.
Osteoradionecrosis of the jaws. Otolaryngologic Clinics of North America 1979;
12:183-186
