Chondroradionecrosis of the larynx: 24‐year University of Wisconsin experience

Abstract

The diagnosis of CRN is challenging, and the likelihood of successful resolution is modest. A high premium should be placed on efforts directed at prevention, such as tobacco and alcohol cessation. © 2017 Wiley Periodicals, Inc. Head Neck 39: 1189-1194, 2017.

Contrast‐enhanced 18F‐FDG‐PET/CT for Differentiating Tumour and Radionecrosis in Head and Neck Cancer: Our experience in 37 Patients

“…The clinical diagnosis of CRN is challenging as RT‐induced changes of the larynx may mimic tumour . Therefore, definitive diagnosis should always integrate a clinical assessment, PET imaging and histopathological diagnosis . In our cohort, the initial T stage was somewhat higher in patients with tumour than in those with radionecrosis.…”

“…In our cohort, the median ORN onset was 5 months after RT, and the bone most commonly affected was the mandible (20/21 patients). Compared to ORN, Gessert et al reported CRN to occur within a longer time interval after RT . The clinical diagnosis of CRN is challenging as RT‐induced changes of the larynx may mimic tumour .…”

“…Treatment strategies for ORN include conservative strategies (antibiotics) and surgical methods . Analogically, the development of chondroradionecrosis (CRN) after radiotherapy for laryngeal and hypopharyngeal cancer is a rare (approximately 2.5% of patients) but severe complication, occurring months to years after treatment . In recent years, (18F) fluoro‐deoxy‐D‐glucose (FDG) positron emission tomography (PET)/computed tomography (CT) has become the cross‐sectional imaging mainstay in the post‐treatment surveillance of patients with advanced HNSCC.…”

Arytenoid Expectoration After Radiotherapy: A Rare Complication of Laryngeal Chondronecrosis

“…Management includes voice rest, humidification, antibiotics, steroids, hyperbaric oxygen, supportive surgery (tracheotomy, gastrotomy tube placement), debridement, and laryngectomy. 2 Cartilage and bone can generally withstand large doses of RT without gross change in tissue. However, histopathologic studies suggest subclinical CRN can occur in rates as high as 27% of larynges previously irradiated for advanced stage laryngeal SCC.…”

“…1 Reported risk factors for the development of laryngeal CRN include ongoing smoking, laryngeal trauma, and tumor cartilage invasion. 2 Typically, CRN manifests with a variety of presenting symptoms including weight loss, hoarseness, odynophagia, dysphagia, laryngeal edema, and upper airway obstruction. 2 Clinical features and imaging can be useful in diagnosis, but definitive diagnosis requires biopsy.…”