Hyperbaric oxygen treatment protocols for mandibular osteoradionecrosis.

To determine hyperbaric oxygen (HBO2) treatment practices for osteoradionecrosis (ORN) of the mandible in North America, we surveyed hyperbaric facilities listed in the 1998 UHMS Chamber Directory. A survey response rate of 99.7% was achieved. Among the 316 facilities listed, 280 treat or would treat mandibular ORN with HBO2. Twelve different hyperbaric treatment protocols for the condition were reported. Approximately three-quarters of facilities utilize a protocol administering 90 minutes of 100% oxygen breathing at a treatment pressure of 2.4-2.5 atmospheres absolute (atm abs). The remaining one-quarter of facilities apply alternate hyperbaric treatment protocols. In summary, mandibular ORN is commonly treated at North American hyperbaric facilities but there is a lack of uniformity with regard to the protocol utilized for hyperbaric oxygen administration. There are no clinical data to support that any one treatment protocol is superior in out come to any other.