Hyperbaric oxygen as an adjunctive treatment for severe laryngeal necrosis: a report of nine consecutive cases.

Laryngeal necrosis is a rare complication of therapeutic radiation, but when it does occur there is no established, definitive treatment and laryngectomy is frequently required. This report is a retrospective review of all patients referred for hyperbaric oxygen (HBO) therapy to a single hyperbaric medicine unit for treatment of their laryngeal necrosis between 1980 and 1985. Nine patients were in this series. One patient had had a vertical hemilaryngectomy and another a supraglottic laryngectomy before referral. Eight of the nine patients had a Chandler grade IV necrosis and the ninth had a Chandler grade III necrosis. All nine patients were able to maintain their voice until death or last follow up. Seven of the nine patients maintained good voice quality while two exhibited some hoarseness. All patients with tracheostomies were able to be decannulated, and all patients with fistulae had these closed. No untoward reactions to HBO occurred. Based on this review, HBO is recommended as a therapeutic option whenever laryngeal necrosis occurs and there is a chance to save the larynx.