The response of the larynx to radical doses of radiotherapy varies from mild erythema to severe inflammation with edema and induration, possibly leading to necrosis of cartilage. Necrosis is mediated by bacterial infection in traumatized tissue having greatly reduced healing power. This complication may be fatal, and if not, its treatment is difficult and lengthy.
Possible etiologic factors discussed include short treatment times, large treatment fields, chronic respiratory tract infection, and generalized arteriosclerosis. Early cases may respond to medical treatment, but once cartilage necrosis has occurred, a laryngectomy is required. Excision of affected neck skin and wound closure at a later date is advocated in order to limit spread of infection.
Stell PM, Morrison MD. Radiation Necrosis of the Larynx: Etiology and Management. Arch Otolaryngol. 1973;98(2):111–113. doi:10.1001/archotol.1973.00780020117011
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