Prevention of Posterior Glottic Stenosis by Mitomycin C

Abstract

Objectives:

Posterior glottic stenosis (PGS) is a disabling disease commonly induced by endolaryngeal injury from intubation or surgery. Few experiments on PGS prevention, however, have been performed. The purpose of this study was to investigate the preventive effect of mitomycin C (MMC) on PGS in a randomized, controlled animal study.

Methods:

Twenty-six rabbits underwent laser injury of 6 W, continuous-focus mode on the posterior glottis. There were 6 uninjured controls. Thirteen animals were treated by a single topical use of 0.4 mg/mL MMC solution on the injured posterior glottis for 5 minutes, and 13 were sham-treated controls. The posterior glottis of all groups was blindly evaluated by telescopic examination under direct laryngoscopy 2 months after injury and was harvested for histologic analyses.

Results:

Scar, granulation tissue, and synechia formation of the posterior glottis were clearly induced by laser injury. Microscopic examination showed increased collagen content and fibroblast proliferation in the region. The use of MMC significantly decreased the incidence of such gross and microscopic changes of the posterior glottis (p < .05).

Conclusions:

This study suggests that topical MMC can be helpful in preventing the progression of PGS from mucosal injury of the posterior glottis.