下顎骨放射線骨壊死に対する高気圧酸素療法の応用

概要

論文の詳細を見る
Five cases of osteoradionecrosis (ORN) of the mandible were treated by hyperbaric oxygen therapy (HBO). In four cases, sequestrectomy in combination with HBO was performed. Furthermore, one of these cases underwent iliac bone grafting and HBO to correct mandibular discontinuity. One case underwent HBO after insertion of an implant into the irradiated mandible. Primary sites, with the histological diagnosis of the tumor and irradiation dose were: tonsil-squamous cell carcinoma (SCC), Linac X-ray 60 Gy; hard palatemalignant pleomorphic adenoma, Tele 60 Co 50 Gy; floor of the mouth-SCC, Tele 60 Co 38 Gy and 198Au grain 98 Gy; tonsil-SCC, Tele 60 Co 60 Gy; tongue-SCC, Linac X-ray 40 Gy. ORN appeared in these five cases 3 years, 24 years, 8 months, 1.5 years and 10 years after irradiation, respectively. HBO was performed under the condition of 2.8 ATA for 60 minutes and the patients were given pure oxygen (51/min) using a reservoir mask. All five cases were successfully treated. Otitis, one of the side effects of HBO, occurred in one case. It was managed by puncture of the tympanic membrane. As ORN is caused by hypoxia of the bone and surrounding tissues, HBO is considered to be one of the basic treatment methods for this condition.
社団法人日本口腔外科学会の論文