Mitomycin: Effects on laryngeal and tracheal stenosis, benefits, and complications

The management of laryngeal and tracheal stenosis continues to challenge us , despite advances in surgical techniques and better understanding of the w ound healing process. Injury to the airway mucosa is the inciting event, re gardless of the cause of the stenosis. Mitomycin-C is an antineoplastic ant ibiotic that acts as an alkylating agent by inhibiting DNA and protein synt hesis. It can inhibit cell division, protein synthesis, and fibroblast prol iferation. Topical application of mitomycin-C (0.4 mg/mL) was used as an ad juvant treatment in the endoscopic laser management of laryngeal and trache al 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 appli cation of mitomycin-C. This study gives promising findings on the efficacy and safety of mitomycin-C as an adjuvant treatment in the management of sel ected cases of laryngeal and tracheal stenosis.