Osteoradionecrosis of the temporal bone: treatment with hyperbaric oxygen therapy

Radiation necrosis is a major complication of surgery or trauma in a previously irradiated field. Although it may occur in any location, the most common region affected is the head and neck. Osteoradionecrosis (ORN), the involvement of bone with radiation necrosis, occurs most frequently in the mandible, and has been well described. Involvement of the temporal bone, although less frequent, is nonetheless a difficult problem in management. Described herein is a case of ORN of the temporal bone treated with adjunctive hyperbaric oxygen therapy with complete resolution. This is followed by a discussion of the pathophysiology, presentation, and management of osteoradionecrosis of the temporal bone, including the role of adjunctive hyperbaric oxygen in the treatment regimen.