Hyperbaric oxygen therapy in the management of radiation-induced injury in the head and neck region: a review of the literature.
OBJECTIVE
Radiotherapy is generally used in the treatment of malignant tumors in the head and neck region. It causes a hypoxic, hypocellular, and hypovascular environment that leads to injury to surrounding normal tissue, both acute and chronic, ranging from xerostomia to osteoradionecrosis. These side effects are debilitating and greatly influence quality of life in these patients. Hyperbaric oxygen (HBO) therapy is clinically used to prevent or treat these side effects by enhancing oxygen pressure and thereby regeneration. Although this therapy is widely applied, its mechanism of action is still poorly understood, and controversy exists in the literature about its clinical use. This review therefore aims to analyze the existing experimental and clinical research on this topic.


METHODS
A systematic search was performed in PubMed for experimental and clinical studies conducted regarding the use of HBO therapy in previously irradiated tissue, in the period from January 1990 to June 2009.


RESULTS
Experimental research is scarce, and clinical studies are especially lacking in terms of randomized controlled studies. Although discussions on the subject are ongoing, most studies suggest a beneficial role for HBO in previously irradiated tissue.


CONCLUSIONS
Further research, both experimental and clinical, is necessary to unravel the working mechanism of HBO therapy and validate its clinical use.
Spiegelberg
Linda
L
Department of Oral and Maxillofacial Surgery, Erasmus MC, University Medical Center, Rotterdam, The Netherlands. l.spiegelberg@erasmusmc.nl
Djasim
Urville M
UM
van Neck
Han W
HW
Wolvius
Eppo B
EB
van der Wal
Karel G
KG
D000818:Animals; D016371:Cranial Irradiation / Q000009:adverse effects*; D006258:Head and Neck Neoplasms / Q000532:radiotherapy; D006801:Humans; D006931:Hyperbaric Oxygenation / Q000706:statistics & numerical data*; D007571:Jaw Diseases / Q000628:therapy*; D010025:Osteoradionecrosis / Q000628:therapy*; D011832:Radiation Injuries / Q000209:etiology / Q000628:therapy*; D014987:Xerostomia / Q000209:etiology / Q000628:therapy