CHONDRORADIONECROSIS AFTER LARYNGEAL RADIOTHERAPY: A NECESSARY EVIL OR AN AVOIDABLE COMPLICATION

TOPIC: Imaging TYPE: Medical Student/Resident Case Reports INTRODUCTION: Organ preservation oncological surgery is the standard of care even in advanced stages laryngeal malignancies. However, certain squamous cell carcinoma, radiotherapy necessary as a first or second line treatment. Chondroradionecrosis (CRN) larynx rare and severe complication radiotherapy, which can have grave consequences if not managed hastily. CASE PRESENTATION: A 51-year-old female with history stage III carcinoma status post-chemotherapy radiation complicated by soft tissue necrosis left vocal cord chronic subglottic stenosis presented to emergency department complaints worsening dyspnea for one week. Recent outpatient micro-laryngoscopy was negative malignancy but showed significant edema narrowing (fig 1). She received hyperbaric oxygen therapy after failing conservative management chondroradionecrosis stopped early due inability tolerate it. review symptoms positive occasional vaping infrequent alcohol consumption. Physical exam on presentation middle-aged acute respiratory distress hoarse voice no stridor. An oropharyngeal revealed whitish plaques posterior pharynx. Vitals signs arrival tachypnea rate 33 breaths/min saturation (SpO2) >92% room air. X-ray neck within region larynx. Soon her arrival, she became increasingly dyspneic, SpO2 decreasing 80%, subsequently intubated using Glide-Scope. CT Soft contrast 2) collapse proximal airway around endotracheal tube, limiting visibility. ENT specialist evaluated recommended switching trans-laryngeal tube tracheostomy severity CRN. underwent percutaneous without any complications. During hospitalization, also treatment candidiasis discharged. DISCUSSION: Radiotherapy causes alterations peri-laryngeal tissues, leading local hypoxia devascularization reduced cellular population, subsequent inflammation fibrosis. According study Wisconsin University, possible factors predisposing postradiotherapy CRN are continual intake post erosion invasion cartilage initial tumor [1]. These findings reiterate importance good counseling regarding tobacco cessation should heighten clinician's suspicion when assessing patients histories these three factors. CONCLUSIONS: There definitive cure sequelae primarily symptomatic rehabilitative. REFERENCE #1: Gessert TG, Britt CJ, Maas AMV, et al. larynx: 24-year University experience. Head Neck 2017; 39:1189–1194. DISCLOSURES: No relevant relationships Manuela Modelewski, source=Web Response Hafiz Muhammad Siddique Qurashi, Navitha Ramesh, Tabinda Saleem,