Topical endotracheal mitomycin C as a complementary treatment for endoscopic treatment of recurrent laryngotracheal stenosis

Abstract

Objective

To describe the preparation of topical endotracheal mitomycin C and the clinical outcomes of four patients with recurrent and severe laryngotracheal stenosis (LTS) treated with adjuvant topical mitomycin C.

Method

Literature review to determine the concentration and method of preparation of topical mitomycin C for endotracheal use. Review of clinical histories.

Results

We established a concentration of 0.4 mg/ml topical mitomycin C for the treatment of laryngotracheal stenosis. In the treated cases, we applied a 0.4 mg/ml solution to the wound site following laser surgery and dilatation with bronchoscope. Three patients remain asymptomatic from a respiratory perspective, and treatment failed in one case.

Conclusions

LTS treatment is complex due to the continuous development of granulation tissue and fibrosis following injury to the airways. Topical mitomycin C seems to be the ideal adjuvant agent thanks to its powerful antifibrotic effects.