Histopathology of laryngeal changes after long-term chondrosynthesis

Two patients treated for laryngeal tumors at the University of Lübeck are presented. Both underwent laryngeal reconstructions with plate and screw fixation systems immediately following partial laryngectomies. Recurrent disease was found at 14 and 55 months, respectively, and was subsequently managed by total laryngectomy. The laryngectomy specimens with the plate and screws in situ were evaluated histopathologically, paying special attention to the reaction of local tissue to the implants. Findings showed that the metallic plates were fixed with screws in the bony trabeculae of the laryngeal skeleton. The histological response showed primary wound healing without evidence of sequestration or implant loosening, as often associated with excess mechanical stress. Furthermore, there were no signs of tissue necrosis or widespread chronic inflammation. In both patients, a small discrete area of chronic inflammation and soft tissue fibrosis was noted adjacent to the screw heads. This study supports our previously documented clinical experience that the use of chondrosynthetic techniques is almost complication-free and is an ideal system for performing precise anatomical reconstruction of the laryngeal skeleton.