Influence of External Pin Fixation Combined With Hyperbaric Oxygen Therapy In Stage 3 Osteoradionecrosis: A Case Series

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ABSTRACT:

Introduction- Osteoradionecrosis is a common complication in head and neck cancer patients undergoing radiotherapy. Hyperbaric oxygen therapy is an effective treatment used in osteoradionecrosis patients accomplished by having the patient breathe 100% oxygen in a pressure-tolerant chamber pressurized at 2.4 atmospheres absolute for 1 hour. External fixation is a minimally invasive procedure of splinting and stablilizing the mandible using pin fixation. Materials and Methods- This prospective study was conducted at Mahatma Gandhi Dental Hospital, Jaipur, India from 2020-2022 to determine the influence of external pin fixation combined with hyperbaric oxygen therapy in stage 3 osteoradionecrosis patients. 8 patients were included in the study. Wound healing was the primary outcome of the study and its evaluation was documented after completion of hyperbaric oxygen therapy and at 6 months on the basis of complete soft tissue coverage to bone without any evidence of infection, inflammation or fistula. Results- After completion of hyperbaric oxygen therapy, external pin fixation combined with therapy has positive effect on wound healing with high success rate in stage 3 osteoradionecrosis patients with 62.5% patients showing complete healing and 37.5% patients showing incomplete healing. At 6 months follow-up, 87.5%  patients showed complete healing and 12.5% patients showed incomplete healing.

KEYWORDS: Radiotherapy, Pathological Fracture, Prophylactic, Wound Healing, Osteoradionecrosis Staging Clinical Presentation Management