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. 2022 Jul;44(7):1646-1654.
doi: 10.1002/hed.27073. Epub 2022 Apr 29.

The impact of hyperbaric oxygen therapy on late irradiation injury in oral microcirculation

Renée Helmers  1   2 , Dan M J Milstein  1 , Nina F Straat  1 , Arash Navran  3 , David N Teguh  4 , Robert A van Hulst  4 , Ludi E Smeele  1   5 , Jan de Lange  1
Affiliations

The impact of hyperbaric oxygen therapy on late irradiation injury in oral microcirculation

Renée Helmers et al. Head Neck. 2022 Jul.

Abstract

Background: Late side effects of radiotherapy in patients with head and neck cancer (HNCPs) result in decreased tissue vascularity, a compromised healing capacity and spontaneous breakdown of tissue. The aim of this study was to examine the in vivo effect of hyperbaric oxygen therapy (HBOT) on the microcirculation in irradiated oral tissue.

Methods: Using a handheld microscope, the effect of HBOT on oral mucosal microcirculation parameters was measured in 34 previously irradiated HNCPs prior to HBOT and at 4 weeks and 6 months posttreatment.

Results: A significant increase in mean buccal vessel density and decrease in buccal vessel diameter was found 6 months after HBOT compared to baseline, 22 ± 11 versus 25 ± 7 cpll/mm2 (p < 0.05) and 20 ± 4 versus 16 ± 5 μm (p < 0.05), respectively.

Conclusion: Our results indicate that oral microcirculation histopathology associated with irradiation is able to respond to HBOT by redirecting oral microcirculation parameters towards values consistent with healthy tissue.

Keywords: head and neck cancer; hyperbaric oxygen therapy; incident dark-field imaging; late irradiation injury; microcirculation.

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Conflict of interest statement

The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.

Figures

FIGURE 1
FIGURE 1
Patient selection flowchart
FIGURE 2
FIGURE 2
CytoCam images illustrating microvascular alterations in IR buccal mucosa observed across all time points: morphologic alterations in the form of telangiectasias or “ballooning” of vessels (black arrows) at T0 For Peer Review (A), T4 (B) and T24 (C), disorganization, malformation and loss of vessel loops (encircled) at T0 (D), T4 (E) and T24 (F). As a comparison, similar to healthy buccal mucosa,16 an example of organized vessel loops of the buccal mucosa observed at T24 weeks (6 months) after start of HBOT (G)
FIGURE 3
FIGURE 3
CytoCam images illustrating mandibular gingival mucosa at T0 (A), T4 (B), and T24 (C) and buccal mucosa at T0 (D), T4 (E), and T24 (F)
See this image and copyright information in PMC

References

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