Late post radiation necrosis and fibrosis of the larynx

Radiation has been used to treat carcinoma of the larynx for some 60 years. We have seen some very late complications of radiation to this region. In this paper we present three patients who had radiation-induced necrosis and fibrosis 13, 19, and 22 years after initial treatment. The problem exists of diagnosing and differentiating perichondritis/fibrosis from recurrent carcinoma. However, many times it is impossible to make this distinction clinically, endoscopically, radiologically, or even pathologically. The pathogenesis, clinical features, and treatment of this rare late complication of radionecrosis and/or fibrosis are presented.