Radiotherapy (RT) is a key component of managing head and neck cancer patients. However, despite the emer- gence and improvement of new RT techniques, late complications may occur, such as osteoradionecrosis of the mandible (ORNM). The diagnosis is based on clinical/radiological criteria. In the established ORNM, the chronic process does not solve spontaneously, and optimal management still needs to be established. Over the last decades, a broad therapeutic spectrum has been considered, including hyperbaric oxygen therapy (HBOT). Al- though, the clinical impact of HBOT varies according to the literature, which is why there is a current controversy regarding its benefits. Further prospective and randomised studies are needed to validate its effectiveness in the ‘real-world’ clinical practice. This article aims to synthesise the existing data, analyse previous studies ́ results, identify gaps in knowledge, and discuss ORNM’ management, including a proposal for an algorithm, with a par- ticular focus on HBOT.

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