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Hill Country Wound Care And Hyperbarics

What to Expect During HBOT for Osteoradionecrosis:
A Patient’s Guide

Starting hyperbaric oxygen therapy (HBOT) for osteoradionecrosis (ORN) can bring up a lot of questions, especially if you’ve never experienced anything like it before.

At Hill Country Wound Care & Hyperbarics, we treat head and neck cancer survivors across San Antonio every week, helping them recover jaw function, reduce pain, and avoid surgery through a proven, physician-led approach to HBOT.

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If you’ve been referred for treatment or are exploring your options, this guide walks you through exactly what to expect before, during, and after therapy, so you can feel confident and prepared.

What Is HBOT and Why Does It Work for ORN?

Osteoradionecrosis (ORN) is a complication of radiation therapy, most commonly affecting the jawbone. After radiation, blood vessels can scar and narrow, reducing oxygen flow to the bone and preventing damaged tissue from healing.

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Hyperbaric oxygen therapy delivers 100% oxygen at increased atmospheric pressure, allowing your blood plasma, not just red blood cells, to carry 10 to 15 times more oxygen to tissues that have been damaged. That oxygen:

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  • Stimulates new blood vessel growth

  • Improves circulation in previously irradiated areas

  • Helps bones regenerate and resist infection

  • Makes surgery and antibiotics more effective

 

HBOT doesn’t just treat ORN, it helps your body recover the capacity to heal itself.

A osteoradionecrosis patient receiving Hyperbaric Oxygen Therapy Treatment in San Antonio.

Your First Appointment: The Consultation

Before any treatment begins, you’ll meet with a board-certified physician at one of our three San Antonio clinics. We’ll:

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  • Review your cancer and radiation history

  • Ask about current symptoms (jaw pain, exposed bone, non-healing ulcers, etc.)

  • Coordinate with your oral surgeon or oncologist

  • Perform a full wound care evaluation

  • Develop a personalized HBOT plan, including pre- and post-surgical sessions if needed

 

We also guide you through your insurance coverage and schedule your treatment sessions to accommodate your availability. Many patients work full- or part-time throughout therapy.

What Happens During an HBOT Session?

Each HBOT session lasts about 90–120 minutes. You’ll lie comfortably in a clear acrylic chamber (Perry monoplace), which allows you to see your surroundings and watch TV or rest.

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Here’s a breakdown of what to expect:

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Step 1: Pressurization

The chamber slowly increases to 2.0–2.5 ATA (atmospheres of pressure). You may feel pressure in your ears, just like during a flight takeoff. Our team will guide you through ear-clearing techniques and monitor you the entire time.

Step 2: Breathing Pure Oxygen

Once at full pressure, you’ll breathe 100% oxygen for the majority of the session. You won’t feel the oxygen, but behind the scenes, it’s being absorbed into your plasma and sent directly to the affected jawbone.

Step 3: Decompression

The chamber slowly returns to normal pressure. You may feel your ears equalize again as you return to a normal position. Then you’re free to get dressed and return to your day.

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Most patients find the experience calming and even relaxing. Our technicians are always just a voice away.

How Many Sessions Will I Need?

We adhere to the proven Marx protocol, backed by decades of clinical success, to guide every step of your hyperbaric oxygen therapy. Typically, treatment begins with 20 to 30 sessions before surgery (if surgical removal of necrotic bone is required), followed by 10 additional sessions afterward. In total, most patients complete between 30 and 40 sessions, attending therapy three to five days per week. The precise number of treatments is tailored to your individual response and surgical needs, and you’ll be re‑evaluated regularly throughout your course to ensure the most effective healing plan.

Is HBOT Safe?

Yes. HBOT is FDA-approved, non-invasive, and monitored in real time. It’s extremely well tolerated. The most common side effects are:

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  • Mild ear pressure (easily managed with ear-clearing techniques)

  • Temporary sinus pressure or fatigue after sessions

  • Rarely, vision changes that reverse after treatment ends

 

At Hill Country Wound Care, your safety and comfort are our top priorities. A physician is always on-site during treatment.

Why Hill Country Wound Care & Hyperbarics? 

We’re San Antonio’s largest physician-led outpatient HBOT network, and we treat osteoradionecrosis with the precision, experience, and compassion patients deserve.

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What Sets Us Apart:

  • Board-certified hyperbaric physicians on-site daily

  • Three easy-to-access locations across San Antonio

  • Comfort-focused Perry chambers with real-time monitoring

  • Proven ORN treatment protocols (based on Marx guidelines)

  • Coordinated care with your oral surgeon or oncologist

  • Transparent pricing and insurance support (note: Hill Country accepts Medicare & Commercial Insurance.)

 

At Hill Country, we don't just provide HBOT, we provide a healing environment.

Hill Country Wound Care And Hyperbarics office location in Live Oak, Texas.
Ready to Heal?

If you’re facing osteoradionecrosis, you don’t have to do it alone, and you don’t have to settle for limited options. Let Hill Country Wound Care & Hyperbarics help you reclaim your jaw health, your comfort, and your confidence.

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