Comparison of Australian and New Zealand referral rates for hyperbaric oxygen in oro-facial osteoradionecrosis: evidence-based, funding constraint or clinician whim?

Abstract

Aim: To compare Australian and New Zealand (NZ) rates of referral to hyperbaric units for patients with, or at risk of developing mandibular or maxillary osteoradionecrosis (ORN) due to a history of radiotherapy for oro-pharyngeal cancer.

Method: Relevant patient treatment data from all hyperbaric units in Australia and NZ were collated and analysed.

Results: The rate of referral to hyperbaric units in Australia for treatment or prophylaxis of patients with, or at risk of oro-facial ORN, was 1.7 times the rate of referral in NZ. Within Australia, there was a greater than three-fold interstate variation.

Conclusion: There is a significant referral rate difference both within Australia and between Australia and NZ for hyperbaric oxygen therapy for oro-facial ORN. Possible reasons for this difference include access to funding, logistical difficulties, clinician preference for an alternative treatment and clinician attitudes to hyperbaric oxygen.

Keywords: Hyperbaric oxygen therapy; evidence; osteoradionecrosis; survey.