We sometimes experience patients with persistent or progressive arytenoid
edema, among which residual or recurrent
cancer is often accompanied. Because it is difficult to distinguish tumour rest or recurrence from normal tissue sequelae in the early period after irradiation, it is important to know both the contributing factors for arytenoid
edema, and the incidence of residual or recurrent tumours in patients with postirradiation
laryngeal edema. We therefore reviewed the charts of 67 patients with early laryngeal
carcinoma who had received a curative dose of irradiation in the last 5 years. Fourteen patients (20.9%) had moderate or severe
laryngeal edema persisting for or developing at more than 3 months after completion of a course of definitive
radiotherapy. The incidence was highest in supraglottic T2 disease, followed by glottic T2 tumour. Of the 14 patients with
edema, six (42.9%) had persistent or recurrent disease. The primary disease was uncontrolled in 18 patients, 17 of whom received successful salvage surgery. In patients without
residual tumours, the
edema was usually moderate and resolved within a year, although four patients had chronic
edema lasting more than a year
after treatment. All four had supraglottic T2 lesions and received 70 Gy of X-ray. We also reviewed, for sake of comparison, the records of 38 patients treated with
radiotherapy at doses of more than 40 Gy between 1975 and 1980, when endoscopic microsurgery for
laryngeal cancer was introduced as a primary part of treatment. The incidence of persistent or late developed
edema over the period, though not significant, was 36.8%: nearly twice that of the last 5 years. Microscopic endolaryngeal
surgical procedures seem to have been a causal factor for
edema in this period.