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Histopathological Study of Radionecrosis in Laryngeal Carcinoma
Author(s) -
Keene Malcolm,
Harwood AndrewR.,
Bryce Douglas P.,
Van Nostrand A. W. Peter
Publication year - 1982
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.1982.92.2.173
Subject(s) - medicine , larynx , laryngectomy , radiation therapy , incidence (geometry) , carcinoma , basal cell , surgery , pathology , physics , optics
With modern radiotherapy techniques, clinical radionecrosis is uncommon following erradication of primary squamous cell carcinoma from the larynx. Histologic sections from 265 specimens, prepared by the technique of whole organ subserial step‐sectioning were studied to determine the incidence and location of chondronecrosis and/or osteomyelitis in both irradiated and non‐irradiated cases. Chondronecrosis occurred in only 1 of 41 early (pT1 ‐ pT2) tumors but in 143 advanced tumors (pT ‐ pT4) treated with radical radiotherapy and containing residual carcinoma, 27% had evidence of significant necrosis, compared with 24% of those not irradiated. Age, sex, tumor grade and previous laryngeal surgery did not appear to be significant factors in the development of necrosis in irradiated patients. The arytenoid cartilage was most frequently involved when chondronecrosis occurred in association with radiotherapy. Six total laryngectomy specimens (3%) were received from patients with symptoms of chondronecrosis and in whom no residual tumor was present. We conclude that although the incidence of clinical perichondritis is low, histologic chondronecrosis andlor osteomyelitis occurred in 26% of all the larynges studied. Radiotherapy appears to be a significant causative factor only in advanced supraglottic tumors.