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Chondroradionecrosis of the larynx: still a diagnostic dilemma

Published online by Cambridge University Press:  29 June 2007

H. Rowley*
Affiliation:
Department of Otolaryngology, Mater Hospital, Dublin. Department of Otolaryngology, Beaumont Hospital, Dublin.
M. Walsh
Affiliation:
Department of Otolaryngology, Beaumont Hospital, Dublin.
D. McShane
Affiliation:
Department of Otolaryngology, Adelaide Hospital, Dublin.
I. Fraser
Affiliation:
Department of Radiotherapy, St Luke's Hospital, Dublin.
T. P. O'Dwyer
Affiliation:
Department of Otolaryngology, Mater Hospital, Dublin.
*
Address for correspondence: Dr Helena Rowley, F.R.C.S.I., Department of Otolaryngology, Royal Liverpool University Hospital, PO Box 147, Prescot Street, Liverpool L69 3BX.

Abstract

Following radiation treatment for carcinoma of the larynx it may be very difficult to differentiate between persistent or recurrent tumour and severe radiation effects particularly chondroradionecrosis. Despite repeated negative biopsy it may be necessary to perform total laryngectomy where the concern about persistent cancer remains and the larynx is non-functioning. We report nine cases presenting as chondroradionecrosis over a five-year period. Two patients settled on medical treatment. Of seven patients treated with laryngectomy the histology on two revealed residual or recurrent carcinoma.

We outline the dilemmas in diagnosis and propose management strategies to deal with this condition including recommendations for prevention and treatment.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 1995

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References

Berger, G., Freeman, J. L., Briant, T. D., Berry, M., Noyek, A. M. (1984) Late post-radiation necrosis and fibrosis of the larynx. Journal of Otolaryngology 13: 160164.Google ScholarPubMed
Chandler, J. R. (1979) Radiation fibrosis and necrosis of the larynx: salvage laryngectomy in the absence of histological confirmation of residual or recurrent carcinoma. Annals of Otology, Rhinologv and Laiyngology 88: 509514.CrossRefGoogle Scholar
Des-Rochers, C., Dische, S., Saunders, M. I. (1992) The problem of cigarette smoking in radiotherapy for cancer of the head and neck. Clinical Oncology (Royal College of Radiologists) 4(4): 214216.CrossRefGoogle Scholar
Flood, L. M., Brightwell, A. P. (1984) Clinical assessment of the irradiated larynx. Journal of Laryngology and Otology 98: 493498CrossRefGoogle ScholarPubMed
Lederman, M. (1972) Radiation therapy in cancer of the larynx. Journal of the American Medical Association 221: 12531254CrossRefGoogle ScholarPubMed
McGovern, F. H., Fitz-Hugh, J. S., Constable, W. (1973) Post–radiation perichondritis and cartilage necrosis of the larynx. Laryngoscope 83: 808813CrossRefGoogle ScholarPubMed
Oppenheimer, R. W., Krespi, Y. P., Einhom, R. K. (1989) Management of laryngeal radionecrosis: animal and clinical experience. Head and Neck Surgery 11: 252256.Google ScholarPubMed
Rugg, T., Saunders, M. I., Dische, S. (1990) Smoking and mucosal reactions to radiotherapy. British Journal of Radiology 63(751): 554556.CrossRefGoogle ScholarPubMed
Schratter, S., Handi-Zeller, L., Strassl, H., Braun, O. M., Dobrowski, W. (1991) Incidence of osteoradionecrosis after combined radiotherapy–chemotherapy of head and neck tumours. Strahlenther-Onkologie 167(3): 165168.Google Scholar
Stell, P. M., Morrison, M. D. (1973) Radiation necrosis of the larynx: etiology and management. Archives of Otolaryngology 98: 111113.CrossRefGoogle ScholarPubMed