Westermark A, Sindet-Pedersen S, Jensen J
Dept. of Oral and Maxillofacial Surgery, Arhus University Hospital, Denmark.
Tandlaegebladet. 1990 Nov;94(16):669-73.
The present paper discuss the development of osteoradionecrosis (ORN) in the jaws. ORN is the end stage of tissue injury induced by irradiation. The most prominent etiologic factor of ORN seems to be the effect of radiation on endothelial cells lining the vessels. These cells are, as tumor cells, highly radiosensitive, and radiation leads to a vascular damage resulting in hypoxic, hypovascular and hypocellular tissues. Wound healing in such tissues is impaired since nutritional demands of the wound, including oxygen, cannot be supplied due to the degenerative changes in the blood vessels. The paper furthermore describes the scientific basis for the use of hyperbaric oxygen therapy (HBO) in ORN. HBO increase the vascularity in the tissues injured by radiation, and thus tissue viability and healing capacity is increased reducing the risk for spontaneous or traumainduced ORN. Protocols for the treatment of patients with ORN are presented and prophylactic guidelines are described.
本文讨论颌骨放射性骨坏死（ORN）的发展。ORN是辐射诱导的组织损伤的终末期。ORN最突出的病因似乎是辐射对血管内衬内皮细胞的影响。这些细胞与肿瘤细胞一样，对辐射高度敏感，辐射导致血管损伤，进而造成组织缺氧、血管减少和细胞减少。由于血管的退行性变化，此类组织中的伤口愈合受损，因为伤口的营养需求（包括氧气）无法得到满足。本文还描述了在ORN中使用高压氧治疗（HBO）的科学依据。HBO可增加受辐射损伤组织的血管形成，从而提高组织活力和愈合能力，降低自发性或创伤性ORN的风险。文中给出了ORN患者的治疗方案并描述了预防指南。
