Impact of radiotherapy on laryngeal intrinsic muscles
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Miroslav Tedla · Matْn Valach · Ricardo L. Carrau · Ivan Varga · Milan Profant · Peter Mrلz · Peter Weismann
- چاپ و سال / کشور: 2011
Description
Ionizing radiation as a cancer therapy is associated with a variety of undesirable side eVects. Consequently, radiotherapy can negatively aVect neuromuscular function. Clinical observations have identiWed problems with swallowing and voice function. Our study aims to evaluate the impact of radiotherapy on laryngeal soft tissues using image analysis to quantify its eVect on the structure of the vocalis and thyroarytenoid muscles. Case control study, retrospective analysis. We collected total laryngectomy specimens from six patients with persistent or recurrent cancer who had received preoperative radiotherapy (60–66 Gy). The control group consisted of total laryngectomy specimens from six patients who underwent surgery as primary treatment. Sampling of the specimens only included non-cancerous laryngeal tissue. Laryngeal histological slices were evaluated using digital morphometric analysis system. Percentage of Wbrosis and density of muscle Wbers within the thyroarytenoid muscle were evaluated in both groups. We found no signiWcant quantitative diVerences in muscle Wbrosis (7.92% vs. 7.52%, P > 0.1). Changes were rather qualitative and included changes in the organization of the muscular Wbers. A signiWcant reduction in muscle Wbers, however, was observed in the samples from irradiated larynges (66.45% vs. 42.03%, P < 0.01). Our analysis suggests that radiotherapy is responsible for a signiWcant reduction in muscle Wbers in the thyroarytenoid muscle and that these changes occur during treatment or relatively early after its completion. Loss of muscle mass after irradiation correlates with clinical observations of muscle weakness and decreased function in patients who undergo radiotherapy.
Eur Arch Otorhinolaryngol DOI 10.1007/s00405-011-1686-8, Received: 22 March 2011 / Accepted: 21 June 2011
