Management of laryngeal chondroradionecrosis: A single-center experience.

IF 2.3 3区医学 Q1 OTORHINOLARYNGOLOGY

Head and Neck-Journal for the Sciences and Specialties of the Head and Neck Pub Date : 2024-08-13 DOI:10.1002/hed.27919

Einav G Levin, Amit Ritter, Gideon Bachar, Aviram Mizrachi, Hagit Shoffel-Havakuk, Noga Kurman, Aron Popovtzer, Yaniv Hamzany

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引用次数: 0

Abstract

Background: 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).

Methods: 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.

Results: 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).

Conclusions: HBOT may benefit in the management of patients with persistence and unresponsive symptoms of LCRN following radiation therapy for laryngeal SCC.

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喉软骨软化症的治疗：单中心经验

背景：喉软骨软化症（LCRN）是放疗的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）的临床益处：我们回顾性分析了一家三级医疗中心在 2006 年至 2019 年期间所有由放射治疗引发的 LCRN 患者。诊断依据是钱德勒分类的体征和症状、影像学和/或组织病理学报告。主要结果是 HBOT 后钱德勒分级的改善情况：结果：在678名接受过放射治疗的喉癌患者中，29人（4.3%）被诊断为LCRN。最常见的主要治疗方法是气管造口术，同时静脉注射类固醇和抗生素（59%）。10名患者接受了HBOT治疗（34.5%），6名患者接受了全喉切除术（21%）。在接受过 HBOT 治疗的患者中，钱德勒评分从中位数 4（范围 2-4）明显降低到 2.5（范围 1-4；P = 0.005）：HBOT可用于治疗喉SCC放疗后LCRN症状持续存在且无反应的患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Head and Neck-Journal for the Sciences and Specialties of the Head and Neck 医学-耳鼻喉科学

CiteScore

7.00

自引率

6.90%

发文量

278

审稿时长

1.6 months

期刊介绍： Head & Neck is an international multidisciplinary publication of original contributions concerning the diagnosis and management of diseases of the head and neck. This area involves the overlapping interests and expertise of several surgical and medical specialties, including general surgery, neurosurgery, otolaryngology, plastic surgery, oral surgery, dermatology, ophthalmology, pathology, radiotherapy, medical oncology, and the corresponding basic sciences.