Consideration of accompanying adult. Ionizing radiation causes an obliterative endarteritis to the main endosteal blood supply of the relevant bone in the radiation therapy field. Histlogically there is osteoblasts and osteocytes with fatty marrow degeneration. Patients receiving radiation to tumors related the mandible develop osteoradionecrosis at five times the rate of patients with tumors of other sites. The risk of osteoradionecrosis is increased significantly at dosages of 6000 cGy or more, the risk is increased twofold for patients receiving greater than 8000 cGy compared to 5000 cGy to 6000 cGy, and is almost five times as great as when the patient receives 4000 cGy to 5000 cGy.
Dentulous patients are more prone to develop osteoradionecrosis than are edentulous patients.
Furthermore, patients with dental disease are at twice the risk of dentulous patients patients without dental disease. The most common problem during hyperbaric oxygen treatment is failure of pressure to equalize on the two sides of the eardrum. This results in squeezing of the delicate vessels of the eardrum, with pain and bleeding into the middle ear. Patients with upper respiratory tract infection or congested mucous membranes are usually placed on prophylactic nasal or systemic decongestants. Myringotomies or pressure-equalizing tubes are resorted to if there is an urgent need for pressurization.