Chondroradionecrosis of the Larynx in a Patient with Laryngeal: A Case Report

Document Type : Case Report

Authors

ENT-Head and Neck Surgery Research Center, Hazrat Rasoul Akram Hospital , Iran University of Medical Science, Tehran, Iran.

Abstract

Introduction:
Actinomycosis of the larynx has been rarely reported in the literature and usually occurs in patients with a history of laryngeal carcinoma and radiation therapy. However, its co-existence with chondroradionecrosis due to radiotherapy is even rarer. The most common site of infection is the cervicofacial region, especially in the submandibular area.
 
Case Report:
Here we report a 63-year-old male with a history of chemoradiotherapy because of laryngeal cancer 1 year earlier who presented with laryngeal actinomycosis. After prolonged penicillin-based treatment, the patient underwent thyroid cartilage defect reconstructive surgery because of a laryngocutaneous fistula due to chondroradionecrosis. The diagnosis, work-up, and management of the case are discussed, as well as a review of the literature.
 
Conclusion:
Although actinomycotic infection of the larynx is rare, it should be considered in the differential diagnosis of laryngeal complaints, especially in immunocompromised patients.

Keywords

Main Subjects

References

1. Batur Calis A, Ozbal AE, Basak T, Turgut S. Laryngeal actinomycosis accompanying laryngeal carcinoma: Report of two cases. Eur Arch Otorhinolaryngol. 2006;263:783–5.
2. Garcia Lozano MC, Perez Sanchez C, Ayala Martinez L. [Laryngeal actinomycosis]. An Otorrinolaringol Ibero Am. 2004;31:237–44.
3. Boyanova L, Kolarov R, Mateva L, Markovska R, Mitov I. Actinomycosis: a frequently forgotten disease. Future Microbiol. 2015;10:613–28.
4. Ghafghaichi L, Troy S, Budvytiene I, Banaei N, Baron EJ. Mixed infection involving Actinomyces, Aggregatibacter, and Fusobacterium species presenting as perispinal tumor. Anaerobe. 2010; 16:174–8.
5. de Andrade AL, Novaes MM, Germano AR, Luz KG, de Almeida Freitas R, Galvao HC. Acute primary actinomycosis involving the hard palate of a diabetic patient. J Oral Maxillofac Surg. 2014; 72: 537–41.
6. McFarlane ME, Coard KC. Actinomycosis of the colon with invasion of the abdominal wall: An uncommon presentation of a colonic tumour. Int J Surg Case Rep. 2010;1:9–11.
7. Ketata S, Ben Mabrouk M, Derbel F, Fodha I, Sabri Y, Trabelsi A, et al. Tumoral form of abdominal actinomycosis: a retrospective case series of seven patients. Rev Med Interne. 2010; 31: 735–41.
8. Reichenbach J, Lopatin U, Mahlaoui N, Beovic B, Siler U, Zbinden R, et al. Actinomyces in chronic granulomatous disease: an emerging and unanticipated pathogen. Clin Infect Dis. 2009; 49: 1703–10.
9. Matsuda K, Nakajima H, Khan KN, Tanigawa T, Hamaguchi D, Kitajima M, et al. Preoperative diagnosis of pelvic actinomycosis by clinical cytology. Int J Womens Health. 2012;4:527–33.
10. Song JU, Park HY, Jeon K, Um SW, Kwon OJ, Koh WJ. Treatment of thoracic actinomycosis: A retrospective analysis of 40 patients. Ann Thorac Med. 2010;5:80–5.
11. Tsuji DH, Fukuda H, Kawasaki Y, Kawaida M, Ohira T. Actinomycosis of the larynx. Auris Nasus Larynx. 1991;18:79–85.
12. Choi MM, Baek JH, Lee JN, Park S, Lee WS. Clinical features of abdominopelvic actinomycosis: report of twenty cases and literature review. Yonsei Med J. 2009;50:555–9.
13. Moghimi M, Salentijn E, Debets-Ossenkop Y, Karagozoglu KH, Forouzanfar T. Treatment of cervicofacial actinomycosis: a report of 19 cases and review of literature. Med Oral Patol Oral Cir Bucal. 2013;18:e627–32.
14.  Abed T, Ahmed J, O'Shea N, Payne S, Watters GW. Primary laryngeal actinomycosis in an immunosuppressed woman: a case report. Ear Nose Throat J. 2013;92:301–3.
15. Patel S, Jaworek AJ, Patel V, Duckworth LV, Sawhney R, Chheda NN. Laryngeal actinomycosis in an immunocompromised patient. J Voice. 2014; 28:838–40.
16. Ferry T, Buiret G, Pignat JC, Chidiac C. Laryngeal actinomycosis mimicking relapse of laryngeal carcinoma in a 67-year-old man. BMJ Case Rep. 2012;30:2012.
17. Balm AJ, Hilgers FJ, Baris G, Keus RB. Pectoralis major muscle transposition: an adjunct to laryngeal preservation in severe chondroradio- necrosis. J Laryngol Otol. 1993; 107: 748–51.
18. Bekiroglu F, Wright S, Grew N. Chondroradionecrosis of larynx following radiotherapy for metastatic neck disease originating from oral carcinoma. Int J Oral Maxillofac Surg. 2007; 36:459–61.
19. Zbaren P, Caversaccio M, Thoeny HC, Nuyens M, Curschmann J, Stauffer E. Radionecrosis or tumor recurrence after radiation of laryngeal and hypopharyngeal carcinomas. Otolaryngol Head Neck Surg. 2006;135:838–43.
20. Naudo P, Laccourreye O, Weinstein G, Jouffre V, Laccourreye H, Brasnu D. Complications and functional outcome after supracricoid partial laryngectomy with cricohyoidoepiglottopexy. Otolaryngol Head Neck Surg. 1998;118:124–9.
21. London SD, Park SS, Gampper TJ, Hoard MA. Hyperbaric oxygen for the management of radionecrosis of bone and cartilage. Laryngoscope. 1998; 108:1291–6.
22. Rowley H, Walsh M, McShane D, Fraser I, O'Dwyer TP. Chondroradionecrosis of the larynx: still a diagnostic dilemma. J Laryngol Otol. 1995; 109:218–20.
23. Halkud R, Shenoy AM, Naik SM, Pasha T, Chavan P, Sidappa KT. Chondroradionecrosis of larynx a delayed complication of radiotherapy: management and review of literature. Indian J Surg Oncol. 2014;5:128-33.
Iranian Journal of Otorhinolaryngology
Volume 29, Issue 3 - Serial Number 92
May and June 2017
Pages 175-180

Files

Share

How to cite

Statistics