PubMed2004
Laryngeal radionecrosis is now an uncommon, late complication after radiotherapy. The authors presented the diagnostic difficulties with differeniation beetween radionecrosis and the recurrent cancer, as well as their own experience with the treatment. The material consisted of 6 cases with radionecrosis (Chandler grade IV) surgically treated during past 15 years. In 3 cases complications occurred in a year after radiotherapy, in 2--ten years and in one--45 years later. In all cases repeated biopses were negative. Laryngeal radionecrosis is life threatening complication, that is why it requires intensive pharmacological and surgical treatment. Despite repeated negative biopses, total laryngectomy is the operation of choice when the larynx is non-functioning. In chosen cases, due to often observed postoperative complications (necrosis of the skin, pharyngeal fistula), indication is the use of artery flaps with simultaneous total laryngectomy.