Premium
Management of laryngeal radionecrosis: Animal and clinical experience
Author(s) -
Oppenheimer Randy W.,
Krespi Yosef P.,
Einhorn Robert K.
Publication year - 1989
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.2880110311
Subject(s) - medicine , tracheotomy , laryngectomy , larynx , surgery , perichondrium , thyroid cartilage , cricoid cartilage , soft tissue , airway , laryngeal neoplasm , radiation therapy , anatomy , cartilage
Radiation necrosis of the laryngeal cartilages is an uncommon complication of radiotheapy for laryngeal carcinoma. It is a devastating process for which there is no one acceptable treatment. Medical management offers only temporary, symptomatic relief, which further necessitates surgical treatment. Surgical management may start with a tracheotomy; however, it often ends with a total laryngectomy. Physiologically, the necrotic cartilages are the source of the problem. It is a general surgical principle that nonviable tissue must be excised to promote healing. Therefore, if the affected laryngeal cartilages were removed, the larynx should heal. Total or near total removal of the thyroid and cricoid cartilages with preservation of the endolaryngeal soft tissues has not been reported in the literature. Theoretically, if the entire cartilaginous framework is removed, there would be no structural support for the airway. We have found using animal models, that submucosal resection of the laryngeal cartilages, leaving the perichondrium and endolaryngeal soft tissues intact can result in a competent airway. Animal and clinical experience will be presented.