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Impact of radiotherapy on laryngeal intrinsic muscles

European Archives of Oto-Rhino-Laryngology volume 269, pages 953–958 (2012)Cite this article

Abstract

Ionizing radiation as a cancer therapy is associated with a variety of undesirable side effects. Consequently, radiotherapy can negatively affect neuromuscular function. Clinical observations have identified 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 effect 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 fibrosis and density of muscle fibers within the thyroarytenoid muscle were evaluated in both groups. We found no significant quantitative differences in muscle fibrosis (7.92% vs. 7.52%, P > 0.1). Changes were rather qualitative and included changes in the organization of the muscular fibers. A significant reduction in muscle fibers, 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 significant reduction in muscle fibers 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.

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Affiliations

  1. 1st ENT Department, Medical School of Comenius University, Antolska 11, 811 07, Bratislava, Slovakia

    Miroslav Tedla & Milan Profant

  2. Institut für Pathologie, Wiener Neustadt, Austria

    Matúš Valach

  3. Department of Otolaryngology—Head and Neck Surgery, The Ohio State University Comprehensive Cancert Hospital and Solove Research Institute, Columbus, OH, USA

    Ricardo L. Carrau

  4. Institute of Histology and Embryology, Medical School of Comenius University, Bratislava, Slovakia

    Ivan Varga

  5. Institute of Anatomy, Medical School of Comenius University, Bratislava, Slovakia

    Peter Mráz & Peter Weismann

Authors
  1. Miroslav Tedla
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  2. Matúš Valach
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  3. Ricardo L. Carrau
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  4. Ivan Varga
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  5. Milan Profant
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  6. Peter Mráz
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  7. Peter Weismann
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Correspondence to Miroslav Tedla.

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Tedla, M., Valach, M., Carrau, R.L. et al. Impact of radiotherapy on laryngeal intrinsic muscles. Eur Arch Otorhinolaryngol 269, 953–958 (2012). https://doi.org/10.1007/s00405-011-1686-8

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  • DOI: https://doi.org/10.1007/s00405-011-1686-8

Keywords

  • Radiotherapy induced changes
  • Dysphagia
  • Picture analysis
  • Intrinsic laryngeal muscles