Levin Einav G, Ritter Amit, Bachar Gideon, Mizrachi Aviram, Shoffel-Havakuk Hagit, Kurman Noga, Popovtzer Aron, Hamzany Yaniv
Department of Otolaryngology - Head and Neck Surgery, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Head Neck. 2025 Jan;47(1):300-308. doi: 10.1002/hed.27919. Epub 2024 Aug 13.
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).
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.
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).
HBOT may benefit in the management of patients with persistence and unresponsive symptoms of LCRN following radiation therapy for laryngeal SCC.
喉软骨放射性坏死（LCRN）是放射治疗一种罕见但严重的并发症。本研究旨在回顾LCRN的治疗方法并评估高压氧治疗（HBOT）的临床疗效。
我们回顾性分析了2006年至2019年在一家三级医疗中心所有放射性LCRN患者。诊断基于钱德勒分类法的体征和症状、影像学和/或组织病理学报告。主要结局是HBOT后钱德勒分级的改善。
在678例接受放疗的喉癌患者中，29例（4.3%）被诊断为LCRN。最常见的初始治疗是气管切开术联合静脉使用类固醇和抗生素（59%）。10例患者接受了HBOT（34.5%），6例接受了全喉切除术（21%）。在接受HBOT治疗的患者中，钱德勒分级从中位数4（范围2-4）显著改善至2.5（范围1-4；p = 0.005）。
对于喉鳞状细胞癌放疗后出现LCRN持续症状且无反应的患者，HBOT治疗可能有益。
