Page 100 - Effects of radiotherapy and hyperbaric oxygen therapy on oral microcirculation Renee Helmers

Chapter 5
support on pathophysiology that was otherwise absent using techniques such as LDF. Doppler optical coherence tomography (DOCT) combined with speckle variance OCT (svOCT) was used to examine angiomorphology and blood flow in the oral mucosa with late irradiation injury.8 Orthogonal polarization spectral imaging (OPSI) and sidestream dark-field imaging (SDFI) have previously been used to describe the microcirculation of oral squamous cell carcinoma 19, microvascular inflammation associated with irradiation-induced oral mucositis in HN cancer patients (HNCP) 14, and the effects of chemotherapy on buccal mucosa in patients with hematological malignancies.19,20 To perform chairside evaluation of the late effects of RT in the oral microcirculation a CytoCam video microscope system, a successor of the OPSI and SDFI instruments, was used.
The aims of this study were to examine whether a chairside assessment approach was feasible to identify and quantify the late effects of RT on the oral microcirculation in patients treated for malignant HN disease. We tested the hypothesis that irradiation elicits detectable (late) oral microcirculatory derangements such as capillary rarefaction, altered angiomorphology, and vessel diameters.
MATERIALS AND METHODS
This single-center observational study was conducted between June 2014 and July 2016 in the Department of Oral and Maxillofacial Surgery of the Academic Medical Center of the University of Amsterdam. The procedures and guidelines for this study were reviewed and approved by the Institutional Medical Ethics Committee of the Academic Medical Center of the University of Amsterdam (Ref. Nos. NL49017.018.14, NL57131.018.16). Signed informed consent was obtained from all participants. This investigation was performed in accordance with the principles established in the Declaration of Helsinki (Fortaleza, October 2013).
Study participants
HNCP referred to the Department of Hyperbaric Medicine (for prophylactic or therapeutic indications) whom previously (>6 months) received uni- or bilateral HN irradiation with >50 Gy were eligible for participation. Patients were excluded if they received hyperbaric baric oxygen therapy in the past, had
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