Radionecrosis of the larynx is a process in which noncancerous tissue sustains damage from radiation. Normal tissue including muscles, cartilage, bone, mucosal lining and blood vessels are affected. The effect on blood vessels is to constrict them or totally occlude them; this is devascularization. This creates loss of blood supply to delicate structures, especially the mucosal lining and cartilages. This may cause the mucosal lining to break down, exposing structures within the larynx or it could scar down, preventing normal laryngeal functions, such as voicing and swallowing. When cartilage is devascularized, it stiffens and stops functioning normally.
When cancerous tissue dies from radiation, it is replaced with scar tissue. The result of the scarring and the unavoidable damage to normal tissue is decreased function. The scarring is not going to get worse once it has stabilized. Though radionecrosis does not occur frequently in radiated larynxes, predisposing factors leading to radionecrosis include radiation dosage, associated chemotherapy, poor general health, tumor invasion of cartilage, and surgical biopsies of the larynx after radiation has been delivered. Treatments can include humidification, steroid therapy, and prolonged antibiotic use. For advanced cases, hyperbaric oxygen (HBO) has been used with very encouraging results.
Larynx radionecrosis radiation oncology, head and neck surgery, and hyperbaric medicine.