Prevention of Infection In Radiated Bone (Osteoradionecrosis)

In this Article

Hyperbaric oxygen therapy is used to prevent osteoradionecrosis [os-tee-oh-rey-dee-oh-nuh-kroh-sis] or exposed bone in people who had radiation therapy and then need surgery or a dental procedure. During hyperbaric oxygen therapy, you breathe pressurized oxygen while you lie inside a clear plastic tube. The extra oxygen helps your body repair itself after surgery and fight off infection. Each treatment can take up to 2 hours. Side effects from the treatment are rare.

What is hyperbaric oxygen therapy?

Hyperbaric [hahy-per-bar-ik] oxygen therapy is a treatment for many kinds of illnesses and injuries. During this treatment, you breathe pure oxygen in a special chamber where the air pressure is two or three times higher than normal. This lets your lungs take in more oxygen than they normally can. The extra oxygen helps your body repair damaged tissue and fight off infection.

What are the risks and/or side effects?

Hyperbaric oxygen therapy is usually considered safe and side effects are rare. However, there are some risks associated with the high air pressure used. These risks include:

  • Ruptured eardrum
  • Collapsed lung
  • Temporary nearsightedness (not being able to clearly see things that are far away). This usually goes away in a few days or weeks after your last treatment.

Another risk with hyperbaric oxygen treatment is seizure caused by too much oxygen in your body.

What are the benefits?

If you have had radiation therapy to treat a cancer, you might develop a bone infection or exposed bone. This usually happens after surgery or a dental procedure. Radiation damages blood vessels and decreases blood flow. This makes it harder for you to heal after surgery or a dental procedure.

Hyperbaric oxygen therapy before surgery or a dental procedure can help you avoid bone infection and bone loss if you had radiation therapy. Hyperbaric oxygen treatments increase the amount of oxygen in your body, helping you build new tissue and repair damaged tissue.

How do I prepare?

You should not drink any alcohol within 8 hours of hyperbaric oxygen therapy.

Because oxygen can cause a fire if there is a spark, you should never bring a lighter or any device with a battery in it into the hyperbaric oxygen treatment area.

Do not use skin care products with petroleum jelly before treatment. Petroleum is also a fire hazard around oxygen.

How is it done or administered?

Hyperbaric oxygen therapy usually is given at a special outpatient clinic. You will lie on a table inside a long clear plastic tube. The tube will be sealed and filled with pressurized oxygen. You might feel popping or fullness in your ears, similar to the way you feel taking off in an airplane. If this happens, it can help to swallow or yawn.

The clinic staff will be able to see and hear you during your treatment and you can talk to them. You should try to relax and breathe normally. Your treatment might take up to 2 hours. Then the tube will be slowly depressurized. You might feel tired or lightheaded afterwards. This should go away soon.

When will I know the results?

You might have 20 hyperbaric oxygen treatments before your surgery or dental procedure, and 10 more treatments afterwards. Your doctor or dentist will check you for signs of osteoradionecrosis.  

What are follow-up requirements and options?

You should keep all of your appointments for hyperbaric oxygen therapy. Each treatment builds on the one before to help you get better.

Quitting smoking can also help improve blood flow and repair damaged tissue.

If you are having a dental procedure, follow your dentist’s instructions for taking care of your mouth after the procedure.

Take all medicines prescribed for you by your doctor or dentist, such as antibiotics (medicine to fight infection).

What should I expect during recovery?

After a hyperbaric oxygen treatment, you should:

  • Get plenty of rest for the next 24 hours.
  • Drink lots of fluids; avoid alcohol and caffeinated drinks such as coffee, tea, and colas.
  • Avoid taking hot showers or tub baths for 24 hours.
  • Do not participate in any strenuous activities for 48 hours.
  • Do not fly in any private or commercial aircraft for at least 24 hours.