Hyperbaric Oxygen Therapy for Radiation Necrosis

Hani L. Ashamalla, MD, Kevin Hardy, MD, and Joel W. Goldwein, MD Last Modified: November 1, 2001

Radiation induced soft-tissue and bone necrosis, while rare, presents a challenge to the treatment team. High radiation doses, previous surgery and trauma all increase the risk of the necrosis. When it develops, pain, disability, progression, or even death due to loss of protective barriers may result. Response to antibiotics and/or conservative debridement can be poor. This is largely due to chronic hypoxia which is characteristic of the necrotic tissue (Marx). Superimposed infectious processes can further compromise the situation. Roughly one-third of osteoradionecrosis occurs spontaneously with soft tissue breakdown over nonviable bone. Trauma such as tooth extraction, biopsy, or placement of dental appliances initiates the other two-thirds.