Page 19 - Effects of radiotherapy and hyperbaric oxygen therapy on oral microcirculation Renee Helmers

General introduction and outline of the thesis
This chapter (Chapter 1) provides a general introduction to ORN, RT, HBOT, the 1 microcirculation and imaging techniques described in this thesis. In Chapter 2
a model is presented in which the aim was to determine whether changes in
the oral microcirculation of the sublingual mucosa could be measured under
influence of changing normobaric and hyperbaric oxygenation settings. The hypothesis that was tested was whether the measured microcirculatory alterations were reversible. The experimental study presented in Chapter 3 investigates the role of HBOT in advancing vascular regeneration in healing of oral mucosal flaps. A wound healing model was used to study and compare the temporal course of mucosal flap vascularization under normal and HBO conditions. In Chapter 4 the onset of LRTI was evaluated overtime in rabbit mandibular mucosa and bone in a pilot IR model. The hypothesis was tested that cumulative IR dosages result in oral mucosal and mandibular bone histopathological changes corresponding to that of LRTI in humans.
In Chapter 5 and Chapter 6 two clinical studies are presented. In Chapter 5 the pathophysiology associated with RT on the oral microcirculation is described and the clinical feasibility of patient-side assessment of late IR oral microvascular changes in HN cancer patients using the CC device was investigated. A final prospective study presents in vivo effects of HBOT on oral microvascular changes associated with late IR injury in HN cancer patients in Chapter 6. The tested hypothesis in this study was that HBOT redirects irradiated oral microcirculation parameters towards levels corresponding to healthy tissue.
All findings are presented and evaluated in the general discussion in Chapter 7 ending with elaboration on future study perspectives. Finally, Chapter 8 presents a general summary of this thesis in both English and Dutch.
17