The Effect of Hyperbaric Oxygenation on Postradiation Xerostomia and Saliva in Patients with Head and Neck Tumours

Abstract

The study was designed to evaluate the influence of hyperbaric oxygenation (HBO) therapy on salivary gland function and the growth of salivary Streptococcus mutans,Lactobacillus and Candida albicans in patients with head and neck tumours who had undergone radiation therapy. Sixteen patients were included, with radiation doses from 58 to 70 Gy. The first examination was performed at baseline before the first HBO therapy (33.7 ± 9 months after radiation therapy), and the second after 20 daily HBO therapies in a hyperbaric chamber at 2.5 ATA (absolute atmospheres), where patients breathed 100% oxygen for 90 min each day. Measurements of salivary flow, buffer capacity, saliva pH and colony density of S. mutans,Lactobacillus and C. albicans in stimulated saliva were conducted, and xerostomia grade was assessed. Salivary flow increased from 0.20 ± 0.1 to 0.39 ± 0.2 ml/min at the end of HBO therapy (p < 0.001). Salivary pH also increased from 6.0 ± 0.2 to 6.5 ± 0.1 (p < 0.05). The colony density decreased from the time at baseline to the end of HBO therapy for S. mutans (p < 0.001), Lactobacillus (p < 0.05) and the fungus C. albicans (p < 0.05). The xerostomia grade decreased from 2.63 ± 0.2 to 1.94 ± 0.2 after HBO (p < 0.001). There was no significant change in buffer capacity. The increased salivary secretion rate and salivary pH, and decreased S. mutans and Lactobacillus colony density that were observed after HBO therapy may reduce caries progression in those patients.

Salivary hypofunction: An update on aetiology, diagnosis and therapeutics

“…Subjective and objective aspects of salivary function are improved with those technique. 189,190 In addition to this, hyperbaric oxygen in irradiated patients demonstrates increased salivary function 191 and reduction in the number of cariogenic bacteria and Candida albicans. Teguh et al 192 pointed out that hyperbaric oxygen favours neoangiogenesis and recruitment of bone marrow stem cells.…”

Hyperbaric oxygen therapy for the treatment of radiation-induced xerostomia: a systematic review

“…Overall, both studies found that HBOT increases stimulated salivary flow rates, implying that HBOT may improve xerostomia. 8,11 Visual analog scale Forner et al also used a 10-mm VAS to assess subjective changes in xerostomia after HBOT. 11 Through this study, he found that all patients had a significant improvement in xerostomia, as determined by their VAS score.…”

“…Affected patients have decreased salivary flow rates and viscous saliva that has less bicarbonate, lysozyme, and immunoglobulins. 4,[7][8][9] This change in the character of the saliva contributes to the sensation of dry mouth; difficulty eating, speaking, and swallowing; and a decline in overall quality of life (QoL). Additionally, the physical changes in saliva create an oral environment prone to infections and dental decay.…”

“…Additionally, the physical changes in saliva create an oral environment prone to infections and dental decay. 4,8,[10][11][12] Radiation-induced xerostomia is common and has a significant impact on patients' lives, leading to a number of therapies that have been studied, but none has been universally accepted. Current treatment modalities include salivary substitutes, muscarinic agonists (e.g., pilocarpine or cevimeline), gustatory stimulation, and acupuncture.…”

Gene Expression Analysis Reveals Inhibition of Radiation-Induced TGFβ-Signaling by Hyperbaric Oxygen Therapy in Mouse Salivary Glands

“…As oxygen under pressure is dissolved in plasma, it can reach otherwise hypoxic areas with obstructed blood flow, like radiation-injured tissues. In the case of the prevention or treatment of xerostomia, some clinical trials report positive effects of HBOT (6)(7)(8), mostly measured by quality of life questionnaires. Experimental evidence on the beneficial effects of HBOT on irradiated salivary glands is however scarce (9).…”