[Clinical indications for laryngectomy in the patients with carcinoma of the larynx after failed radiotherapy].

The authors present 22 patients with carcinoma of the larynx after radiotherapy in which laryngectomy was performed basing on the clinical view, without repeated histological confirmation of the tumour. In this material there were 14 patients without any biopsies after radiotherapy, and 8, in whom biopsies were performed once or twice, but no evidence of tumour was found. During microscopic studies of postoperative specimens the tumour was found in 21 cases-in one case pre-operative changes were caused by postradition injuries (inflammation, necrosis). The authors discuss clinical signs, which can be helpful to recognize the presence of tumour with postradiation changes and which gives a reason for laryngectomy following radiotherapy. This signs were: persisting or progressive post-radiation oedema of the larynx, laryngeal wall swelling (especially dissimmetrical), vocal cord fixation after radiotherapy, mucosal ulceration of the laryngeal wall and lymph nodes palpability on the neck after radiotherapy.