1、Hyperbaric Oxygen Treatment Protocols for Mandibular OsteoradionecrosisTe-Chun Hsia Abstract fromUndersea and Hyperbaric Medical Society, 2003Introduction 5000 cent-gray Progressive radiation fibrosis Capillary loss Mandible Dense, poorly vascularised bone Neck and head area radiation injury Mark us
2、ed HBO2 treatment Stimulate angiogenesis and Fibroplasia in affected tissueMethod Mail survey Mailings Telephone calls Electronic mailResults 316 htperbaric chamber facilities 315 responded to the survey 12 different protocolsHyperbaric protocols for osteoradionecrosisProtocol Facilities Pressure#1
3、(atm abs)Oxygen time#1(min)Pressure#2 (atm abs)Oxygen time #2(min)1 1 2.4 70-802 1 1.9 903 48 2.0 904 1 2.5 30 2.0 605 3 2.2 906 1 2.4 857 134 2.4 908 71 2.5 909 1 2.4 80 0.6 6010 13 2.0 12011 2 2.4 12012 4 2.5 120Results27%49%22%2%Discussion used 2.4 to 2.5 atm 90 min protocol Rabbits studies Press
4、ure-response curve 1.5 to 3.0 atm, increasing effect on angiogenesis Pressure-time response curve Dose response curve Recommended 2.5 atm abs to balance the benefit of HBO2 with an acceptable level of treatment risk for clinical oxygen toxicityDiscussion Is 1.9 atm abs enough? Ehlers study 1.9 atm , only 60% of the capillary density that would be achieved by treatment at 2.5 atm abs.
