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- This topic has 2 replies, 2 voices, and was last updated 29/01/2012 at 4:43 pm by Drsumitra.
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05/07/2010 at 9:50 pm #9392tirathOfflineRegistered On: 31/10/2009Topics: 353Replies: 226Has thanked: 0 timesBeen thanked: 0 times
When osteoradionecrosis develops, tissue destruction devolves into breakdown of overlying tissues and symptomatic destruction of bone. During this process, the response to antibiotics can be poor. In many cases, the situation can be improved with the use of HBO therapy. Hyperbaric oxygen has been shown to be more effective than penicillin. Patients being treated with penicillin typically show a significantly higher rate of necrosis than those being treated with hyperbaric oxygen, with only five to thirty percent of patients able to expect remission of ORN through conservative therapy. HBO therapy is especially beneficial for high-risk patients, such as irradiated patients requiring tooth extraction. Hyperbaric treatment allows more oxygen to reach the damaged areas, and helps prevent tissues from dying from lack of blood and oxygen flow. The therapy is painless, and it is capable of producing a wide range of effects, including increased oxygen delivery to injured tissue, greater blood vessel formation, advanced wound healing, improved infection control, preservation of damaged tissue, elimination of toxic substances, and reduced effects from toxic substances. Hyperbaric oxygen therapy appears to assist in salvaging tissue damaged by radiation therapy by stimulating angioneogenesis in tissue that is even marginally viable. In reconstructive surgery involving irradiated tissue, HBO treatment prior to surgery can help promote a well-vascularized wound, enhancing healing and the reconstructive process.
05/07/2010 at 9:52 pm #13996tirathOfflineRegistered On: 31/10/2009Topics: 353Replies: 226Has thanked: 0 timesBeen thanked: 0 timesMonoplace and Multiplace Chambers
Hyperbaric oxygen therapy can be conducted in single person chambers, or in chambers that can hold more than a dozen people at a time. During therapy in a monoplace chamber, a single patient is placed in a pressurized clear, acrylic chamber, about seven feet long, while pure oxygen is compressed into the chamber. The chamber is comfortable, with an atmosphere similar to that of an airplane. The patient lies on a padded table that slides into the tube, and is asked to relax and breath normally as the chamber is gradually pressurized with pure oxygen. Chamber pressures typically rise to two-and-a-half times the normal atmospheric pressure. Ear popping or mild discomfort may be experienced, but this generally subsides if the pressure is lowered. The session can last anywhere from thirty minutes to two hours, at the end of which technicians slowly depressurize the chamber.Monoplace chambers cost less to operate than multiplace chambers and are relatively portable. Monoplace chambers are also far less expensive than their larger counterparts, a fact that has allowed hospitals to institute HBO programs more cost effectively. The internal environment of a monoplace chamber is maintained at 100% oxygen, so the patient does not need to wear a mask.
Multiplace chambers are large tanks able to accommodate anywhere from two to fourteen people. These chambers are commonly built to reach pressures up to 6 atmospheres and have a chamber lock entry system that allows medical personnel to pass through without altering the pressure of the inner chamber. This system allows patients to be directly cared for by staff within the chamber. The chamber is filled with compressed air, and patients breathe 100% oxygen through a facemask, head hood, or endotracheal tube.
29/01/2012 at 4:43 pm #15103DrsumitraOfflineRegistered On: 06/10/2011Topics: 238Replies: 542Has thanked: 0 timesBeen thanked: 0 timesA literature review conducted by Spiegelberg, et al focused on the use of hyperbaric oxygen (HBO) therapy in the management of radiation-induced injury in the head and neck region. A systematic search in PubMed focused on experimental and clinical studies involving the use of HBO therapy in previously irradiated tissue that were conducted from January 1990 through June 2009. Radiotherapy is used in treating malignant tumors in the head and neck region, and can result in a hypoxic, hypocellular, hypovascular environment which causes injury to surrounding normal tissue. The use of HBO therapy in improving wound healing is based on the principle that delivery of oxygen is an essential process when considering tissue (bone) repair. Although HBO therapy is widely applied, its mechanism of action is still poorly understood, and there is controversy over its clinical use. This literature review found that experimental research involving HBO therapy is scarce, and there is a lack of randomized controlled clinical trials. The review concludes that more research, both clinical and experimental, is necessary before solid conclusions can be drawn regarding the use of HBO therapy in the management of radiation-induced injury to the head and neck region
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