Delayed Radionecrosis of the Larynx

지연성 후두방사선괴사에 대한 고찰

Radiation therapy is an effective treatment modality for malignant disease of the head and neck, but it is not without risk and complication. Response of the larynx to radiotherapy varies from mild erythema to severe inflammation with edema and induration. possibly leading to necrosis of cartilage. These changes are due to an inflammatory reaction characterized by infiltration of polymorphonuclear leukocytes, vascular thrombosis, and obliteration of lymphatic channels. Late changes consist of telangiectasia of the skin, alopecia, loss of subcutaneous fat, degenerative changes in the connective tissues. But, radiation necrosis of laryngeal cartilage is an uncommon complication and it is a devastating process for which further necessitates surgical treatment. It is generally agreed that the only treatment for patient not responding to conservative measures is a total laryngectomy. We experienced 4 cases of delayed radionecrosis of the larynx who underwent radiation therapy for glottic cancer and hypopharyngeal cancer. We report these cases with review of literature.