REZA RAHBAR, DMD, MD; STANLEY M. SHAPSHAY, MD; GERALD
B. HEALY, MD
BOSTON, MASSACHUSETTS
The management of laryngeal and tracheal stenosis continues to challenge
us, despite advances in surgical techniques and better understanding of the
wound healing process. Injury to the airway mucosa is the inciting event,
regardless of the cause of the stenosis. Mitomycin-C is an antineoplastic
antibiotic that acts as an alkylating agent by inhibiting DNA and protein
synthesis. It can inhibit cell division, protein synthesis, and fibroblast
proliferation. Topical application of mitomycin-C (0.4 mg/mL) was used as
an adjuvant treatment in the endoscopic laser management of laryngeal and
tracheal stenosis in 15 patients. Fourteen patients (93%) have shown improvement
of their airway and resolution of their preoperative symptoms. After a mean
follow-up of 18 months, no complication was noted with regard to the application
of mitomycin-C. This study gives promising findings on the efficacy and safety
of mitomycinC as an adjuvant treatment in the management of selected cases
of laryngeal and tracheal stenosis. |