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ROENTGEN RADIATION NECROSIS OF LARYNX AND OTHER STRUCTURES OF THE NECK

PETER A. NELSON, M.D.; EDWIN F. HIRSCH, M.D.
JAMA. 1935;104(18):1576-1578. doi:10.1001/jama.1935.02760180008002.
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According to Hahn,1 when irradiation in 1910-1912 replaced surgery in the treatment of tuberculosis of the neck, many patients suffered roentgen injuries of the throat. Even after the radiation had been reduced to three fourths of the toxic skin dose, patients so treated, after several weeks, became hoarse. Because these patients had no skin reaction, their hoarseness was not associated with the radiation therapy. As the number of patients with hoarseness increased and examinations of the larynx demonstrated an obstinate edema which lasted several weeks, radiation was recognized as the etiologic agent. The only reference to irradiation injury of the throat at that time, according to Hahn, was by Mühlmann, who had often noted a stubborn hoarseness in irradiated patients and, in two, a chronic laryngitis. Other reports of severe damage to the larynx and tissues of the neck by radiation were published in 1921 by Wetzel,2 Holfelder,

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