Page 98 - Effects of radiotherapy and hyperbaric oxygen therapy on oral microcirculation Renee Helmers

Chapter 5
ABSTRACT
Objectives: Late radiation-induced tissue toxicity in the head and neck (HN) region is associated with ulceration and osteoradionecrosis as a result of a detrimental effect on the underlying tissue microvasculature. The aim of this investigation was to determine the clinical feasibility of examining and measuring late irradiation changes in the oral microcirculation of HN cancer patients using the novel CytoCam video microscope system.
Materials and methods: In 30 HN cancer patients and 30 age-matched controls, bilateral video images were recorded noninvasively of the oral microcirculation of the buccal mucosa and mandibular gingiva. Tissue perfusion parameters such as functional capillary density (FCD), buccal blood vessel diameter (Øbv), and microcirculatory flow index (MFI) were analyzed.
Results: No difference was observed for mean buccal mucosa FCD in
irradiated vs. healthy tissue, whereas a lower mean gingival FCD in
irradiated vs. healthy tissue was observed (34±17 cpll/mm2 vs. 68±19 cpll/
mm2; p<0.001). A significant difference in mean buccal Ø of 16±3 mm bv
was measured compared to 14±1 mm in control buccal mucosa (p<0.001). No significant difference in MFI was observed between the two groups. Conclusion: Quantifying oral microcirculatory injury associated with late irradiation effects using the CytoCam was feasible in HN cancer patients. Results indicate that marked differences in tissue-specific microcirculatory measurements of angioarchitecture, diminished capillary density, and extensively dilated blood vessel diameters are associated with late irradiation effects in HN cancer patients.
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