Page 118 - Effects of radiotherapy and hyperbaric oxygen therapy on oral microcirculation Renee Helmers

Chapter 6
on incident dark-field illumination imaging (IDFI). Large vessel diameters in buccal mucosa and a reduction in vessel density in mandibular gingiva was observed and morphologic observations showed telangiectasias in the oral mucosa consistent with injured microvascular endothelium.12 The in vivo net effect of HBOT over time on reconstitution of adequate tissue perfusion and tissue vitality associated with irradiated oral tissue has not yet been elucidated on the level of individual vessels. In this study the aim was to monitor in vivo the effects of HBOT prospectively on irradiated oral microcirculation with the use of the CC microscope system. We tested the hypothesis that HBOT redirects microcirculation parameters such as functional capillary density (FCD), blood vessel diameters (Øbv) and angiomorphology towards levels corresponding with healthy tissue.
MATERIALS AND METHODS
A prospective observational study was conducted between November 2014 and July 2017 in the Department of Hyperbaric Medicine and the Department of Oral and Maxillofacial Surgery of the Amsterdam University Medical Centre (UMC), location AMC. The institutional medical ethics committee of the Amsterdam UMC/AMC (Ref. Nr. NL49017.018.14) approved all procedures and guidelines of the study, which were performed in accordance with the principles established in the Declaration of Helsinki (Fortaleza, October 2013).
Patients
Head and neck cancer patients (HNCPs), previously treated with RT, that were referred to the Department of Hyperbaric Medicine for either prophylactic or therapeutic HBOT indications were included in this study. Inclusion criteria were a minimum dose of 50 Gy RT received >6 months prior to participation. Exclusion criteria were surgery in the HN region or HBOT 6 months previous to the study and severe trismus preventing adequate mouth opening for measuring intraorally. Furthermore, patients that received <20 HBOT sessions in total were excluded from the study. History of general health and IR-dose was acquired from medical records after patient approval. Smoking status was based on information provided by the patient. Dentate or edentulous state was noted.
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