Management of laryngeal chondroradionecrosis: A single‐center experience

• Published in: Head & neck 2025-01, Vol.47 (1), p.300-308
• Main Authors: Levin, Einav G., Ritter, Amit, Bachar, Gideon, Mizrachi, Aviram, Shoffel‐Havakuk, Hagit, Kurman, Noga, Popovtzer, Aron, Hamzany, Yaniv
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Antibiotics; chondroradionecrosis; Female; Humans; Hyperbaric oxygen therapy; Hyperbaric Oxygenation; Laryngeal cancer; Laryngeal Diseases - etiology; Laryngeal Diseases - therapy; Laryngeal Neoplasms - pathology; Laryngeal Neoplasms - radiotherapy; Laryngeal Neoplasms - therapy; Laryngectomy - adverse effects; larynx; Male; Middle Aged; Original; Ostomy; Patients; Radiation Injuries - therapy; Radiation therapy; radiation‐induced complications; Retrospective Studies; Steroid hormones; Tracheostomy; Treatment Outcome
• ISSN: 1043-3074; 1097-0347; 1097-0347
• DOI: 10.1002/hed.27919

Background Laryngeal chondroradionecrosis (LCRN) is a rare but severe complication of radiation therapy. The study aimed to review the management of LCRN and evaluate the clinical benefit of hyperbaric oxygen therapy (HBOT). Methods We retrospectively analyzed all radiation‐induced LCRN patients between 2006 and 2019 at a tertiary medical center. Diagnosis was based on signs and symptoms of Chandler's classification, imaging, and/or histopathology report. The primary outcome was improvement in Chandler's grade after HBOT. Results Of 678 irradiated laryngeal cancer patients, 29 (4.3%) were diagnosed with LCRN. The most common primary management was tracheostomy with intravenous steroids and antibiotics (59%). Ten patients received HBOT (34.5%), and six underwent total laryngectomy (21%). In HBOT‐treated patients, Chandler's grade significantly improved from a median of 4 (range 2–4) to 2.5 (range 1–4; p = 0.005). Conclusions HBOT may benefit in the management of patients with persistence and unresponsive symptoms of LCRN following radiation therapy for laryngeal SCC.