Office-Based Mitomycin-C Application to Prevent Postoperative Laryngeal Stenosis

Jang, Jeon-Yeob; Lee, Gil-Joon; Son, Young-Ik

J Korean Soc Laryngol Phoniatr Logop > Volume 20(1); 2009 > Article

Journal of The Korean Society of Laryngology, Phoniatrics and Logopedics 2009;20(1): 36-41.

술 후 후두협착을 예방하기 위한 외래에서의 Mitomycin-C의 반복 국소적용

장전엽, 이길준, 손영익

성균관대학교 의과대학 삼성서울병원 이비인후과학교실

Office-Based Mitomycin-C Application to Prevent Postoperative Laryngeal Stenosis

Jeon-Yeob Jang, Gil-Joon Lee, Young-Ik Son

Department of Otorhinolaryngology-Head and Neck Surgery, Sungkyunkwan University School of Medicine Samsung Medical Center

ABSTRACT

Background and Objectives:
Topical administration of mitomycin-C (MMC) has been reported to reduce or delay scar formation in airway surgery. However, it is not infrequent to experience recurrent stenosis or adhesion of operative wound even after a meticulous MMC application during the laryngeal surgery. Therefore we aimed to evaluate the effectiveness of repeated postoperative MMC applications and the technical feasibility of MMC applications to the laryngeal wound at an outpatient clinic.
Method:
We reviewed medical records of 13 consecutive patients who received office-based MMC applications after laryngeal airway surgery at Samsung Medical Center, Seoul, Korea. The patients were grouped into 3 categories according to the site of surgical wound and the purpose of MMC application; group I : supraglottic stenosis (n=5), group II : cordectomy and arytenoidectomy site granulation prevention (n=3), Group III : laryngeal web prevention (n=5). Outcomes in each group and adverse effects of repeated MMC applications were evaluated.
Results:
Office-based MMC application was successfully performed one to four times with a week interval for each patient. No significant complications were observed except slightly decreased mucosal wave in one female patient who received 4 times of MMC application at the anterior commissure of vocal fold. Repeated MMC applications at the outpatient clinic resulted in wide or acceptable supraglottic airway in group I, clean wound healing without granulation formation in group II, and negligible or no web formation at the anterior commissure in group III.
Conclusion
: Office-based topical administration of MMC to the larynx was technically feasible. Postoperative repeated MMC applications were effective to reduce recurrent stenosis or adhesion of supraglottic structures, to prevent granuloma formation after laser arytenoidectomy and glottic web formation after anterior commissure resection.

KEY WORDS： Mitomycin;Administration;topical;Office-based procedures;Laryngostenosis;Prevention and control;

중심 단어： 국소도포;외래처치;후두협착;예방 및 치료;