The influence of hyperbaric oxygen on the outcome of patients treated for osteoradionecrosis: 8 year study.

This study was a retrospective review of treatment outcomes of osteoradionecrosis (ORN) of the mandible over an 8-year period, with specific reference to the role of hyperbaric oxygen therapy (HBOT). The presentation and management of 23 patients treated for ORN was studied by categorising them into three grades according to the severity of clinical and radiographic involvement. At presentation there were 13 patients with grade I ORN, six patients with grade II ORN and four patients with grade III ORN. HBOT was given to 10 patients in the grade I group, four patients in the grade II group and two patients in the grade III group. Overall eight patients (62%) with grade I, three patients (50%) with grade II and two patients (50%) with grade III were cured. In the patients who received HBOT the cure rate was 12.5% whilst in those without HBOT it was 86%. Although the cohort was small it seems that HBOT was of little benefit. HBOT is demanding for patients and has cost implications for the NHS; hence further clinical outcome data are urgently required with regard to its role in the management of ORN.