Preservation of a radionecrotic larynx by excision of thyroid cartilage with flap coverage

Necrosis of the larynx following radiation therapy is a rare complication leading to severe disability and even death. Generally accepted treatment has consisted of incision and drainage, debridement, and tracheotomy or even total laryngectomy. One patient developed chondronecrosis of the thyroid cartilage and was treated by excision of the entire thyroid cartilage and overlying skin with subsequent coverage by a unipedicled cervicothoracic flap. The patient has had his tracheotomy corked or been decannulated for 11 months with preservation of a useable larynx.