Following radiation treatment for carcinoma of the larynx it may be ve
ry difficult to differentiate between persistent or recurrent tumour a
nd severe radiation effects particularly chondroradionecrosis. Despite
repeated negative biopsy it may be necessary to perform total larynge
ctomy where the concern about persistent cancer remains and the larynx
is non-functioning. We report nine cases presenting as chondroradione
crosis over a five-year period. Two patients settled on medical treatm
ent. Of seven patients treated with laryngectomy the histology on two
revealed residual or recurrent carcinoma. We outline the dilemmas in d
iagnosis and propose management strategies to deal with this condition
including recommendations for prevention and treatment.