Slow-Release 5-Fluorouracil and Triamcinolone Reduces Subglottic Stenosis in a Rabbit Model

Abstract

A previous pilot study suggested that a sustained-release conjugate that provided a slow release of 5-fluorouracil and triamcinolone acetonide injected into the tracheal and paratracheal tissues of rabbits at the time of subglottic surgery reduced the formation of subglottic stenosis. Our study was undertaken to confirm the effect. Ten milligrams of the compound suspended in hyaluronic acid was injected at the time of injury via a laryngofissure approach. The results showed that the control group had a mean stenosis of 52%, whereas the treated group had a mean stenosis of 32%. There was a significant difference between the treated and untreated groups (p = 003). It is hoped that this co-drug ultimately can be used in humans to reduce stenosis formation after laryngotracheal surgery and in other forms of otorhinolaryngological surgery.

Keywords

5-fluorouracil subglottic stenosis triamcinolone acetonide

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References

McDonald

Stocks

. Prolonged nasotracheal intubation: a review of its development in a paediatric hospital. Br J Anaesth 1965; 37: 161–73.

Holinger

. Clinical aspects of congenital anomalies of the larynx, trachea, bronchi and oesophagus. J Laryngol Otol 1961; 75: 1–44.

Cotton

. Pediatric laryngotracheal stenosis. J Pediatr Surg 1984; 19: 699–704.

Cotton

. The problem of pediatric laryngotracheal stenosis: a clinical and experimental study of the efficacy of autogenous cartilaginous grafts placed between the vertically divided halves of the posterior lamina of the cricoid cartilage. Laryngoscope 1991; 101: 1–34.

Shapshay

Beamis

Jr Hybels

Bohigian

. Endoscopic treatment of subglottic and tracheal stenosis by radial laser incision and dilation. Ann Otol Rhinol Laryngol 1987; 96: 661–4.

Simpson

Strong

Healy

Shapshay

Vaughan

. Predictive factors of success or failure in the endoscopic management of laryngeal and tracheal stenosis. Ann Otol Rhinol Laryngol 1982; 91: 384–8.

Cotton

Seid

. Management of the extubation problem in the premature child: anterior cricoid split as an alternative to tracheotomy. Ann Otol Rhinol Laryngol 1980; 89: 508–11.

Cotton

. Management of subglottic stenosis in infancy and childhood: review of a consecutive series of cases managed by surgical reconstruction. Ann Otol Rhinol Laryngol 1978; 87: 649–57.

Cotton

Evans

JNG

. Laryngotracheal reconstruction in children: five-year follow-up. Ann Otol Rhinol Laryngol 1981; 90: 516–20.

10.

Campbell

Dennison

Durkin

Strigenz

Toohill

. Early and late dilatation for acquired subglottic stenosis. Otolaryngol Head Neck Surg 1986; 95: 566–73.

11.

Madhat

Baker

Huffman

Ashton

. 5-Fluorouracil—triamcinolone codrug implant to control scar formation in strabismus surgery [Abstract]. J Invest Ophthalmol Vis Sci 1994; 35: 4378.

12.

Jampal

. Effect of brief exposure to mitomycin C on viability and proliferation of cultured human Tenon's capsule fibroblasts. Ophthalmology 1992; 99: 1471–6.

13.

Ingrams

Sukin

Ashton

Valtonen

Pankratov

Shapshay

. Does slow release 5-fluorouracil and triamcinolone reduce subglottic stenosis?. Otolaryngol Head Neck Surg 1998; 118: 174–7.

14.

Browner

Black

Newman

Hulley

. Estimating sample size and power. In: Hulley

Cumming

, eds. Designing clinical research. Baltimore, Md: Williams and Wilkins, 1998: 139–50.

15.

Brierly

Brown

Pearson

. 5FU prodrug for the treatment of epithelial downgrowth [Abstract]. J Invest Ophthalmol Vis Sci 1995; 36: 411.