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MANDIBULER OSTEORADYONEKROZDA HİPERBARİK OKSİJEN TEDAVİ PROTOKOLÜ

HYPERBARIC OXYGEN THERAPY PROTOCOL IN MANDIBULAR OSTEORADIONECROSIS

Journal Name:

  • İstanbul Üniversitesi Diş Hekimliği Fakültesi Dergisi

Publication Year:

  • 1995

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Osteoradionecrosis is a complication seen after head and neck region tumour radiotherapy which might develop especially in mandibula independent of surgical intervention. The old fashioned concept was, trauma, and infection was leading to osteoraidonecrosis. The new concept is a chronic, unhealed wound of the hypoxic, hypovascular and hypocel hilar character gaining tissue of radiation therapy. Tooth extraction and tumor surgery like procedures before radiation may lead to osteonecrosis. The best was to prevent this is to perform these procedures at least three weeks before ra-diothrapy. However, studies performed in recent years reveal that tooth extraction which might not cause osteoradionecrosis in thefirst year but may result even after four years. Therefore if surgical procedure needed after radiotharapy it should be done just after the early recovery period due to the progressive changes of the tissue. All the reasons that lead to osteoradionecrosis put hyperbaric oxygen therapy to thefirst step in treating this complication because of vie antihypoxic, antibacterial and neovascla-fixation effect of hyperbaric oxygen. Therefore, medical and surgical treament of mandibular osteoradionecrosis should be combined with HBO in a protocol for gaining better sue-ces and prevention.
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Abstract (Original Language): 
Osteoradyonekroz, baş ve boyun bölgesi tümörlerinin radyoterapisi sonrası cerrahi müdahaleye bağlı olmaksızın da özellikle mandibulada gelişebilen bir kompli-kasyondur. Eski yaklaşım osteoradyonekrozu radyoterapi uygulanmış bölgede travma ve enfeksiyon nedeniyle gelişen bir lezyon olarak tanımlamaktaydı. Yeni yaklaşıma göre ise osteoradyonekroz, radyoterapi uygulaması sonrası hİpoksik, hipovasküler ve hiposelü-ler bir karakter kazanan dokuda gelişen bir tür iyileşmeyen yaradır. Radyasy on öncesi diş çekimi ve tümör cerrahisi gibi girişimler de osteonekrozla sonlanabilir. Bu durumdan korunmanın en uygun yolu girişimlerin radyoterapiden en az üç hafta önce yapılmasıdır. Ancak son yıllardaki çalışmalar ilk yıl içinde osteoradyo-nekroza neden olmayacak bir diş çekiminin dördüncü yılda bu sonucu doğurabileceğim göstermektedir. Bundan dolayı radyoterapi sonrası gerekebilecek bir cerrahi girişim, dokunun hipoksik karakteri progresif olduğundan, akut iyileşme döneminin hemen ardından yapılmalıdır. Osteoradyonekrozun gelişimini ortaya çıkaran tüm bu nedenlerden ötürü antihipoksit, antibakteriyel ve neo-vaskülarizasyonu restore edici etkilere sahip hiperba-rik oksijen (HBO) tedavisinin kullanımı ön plana çıkmıştır. Medikal, cerrahi ve HBO tedavisinin belirli bir protokolle ve uygun zamanlama ile yürütülmesi, man-dibuler osteoradyonekrozda koruyucu ve tedavi edici yararlar sağlar.
FULL TEXT (PDF): 
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REFERENCES

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