Management of laryngeal chondroradionecrosis with pentoxifylline and vitamin E: A case report and review of the literature

Abstract

Laryngeal chondroradionecrosis (LCRN) is a rare complication characterised by radiation-induced fibro-atrophy and necrosis of the laryngeal cartilage. There is a mixed consensus on treatment strategy with limited cases reported in the literature. A 60-year-old female patient with a history of a poorly differentiated T3N0M0 glottic laryngeal squamous cell carcinoma treated via chemo-radiotherapy presented 18 months following treatment with discomfort of her throat and difficulty swallowing. Imaging showed fracture of the right lamina of the thyroid cartilage with accompanying soft tissue swelling representative of LCRN. A combination of pentoxifylline and tocopherol (vitamin E) (PENTO) was prescribed on the principle of managing radiation induced fibrosis. At the 1-month review, the patient's throat pain had resolved and her swallowing had improved. A further 2 months later a nasoendoscopy showed no evidence of LCRN. The PENTO protocol has been a successful management strategy in this case in the medium term.