후두협착 및 후두 육아종 수술시 Mitomycin-C 효과에 대한 예비적 보고

Abstract

Background and Objectives：Mitomycin-C is an antibiotic, antineoplastic agent that inhibits DNA and protein synthesis, and fibroblast proliferation. It has been successfully used in adjunction to glaucoma surgery, dacryocystorhinostomy, pterygium surgery, and middle meatal antrostomy. The purpose of this study is to evaluate the efficacy and safety of intraoperative Mitomycin-C application as an adjunct therapy in the endoscopic treatment of laryngeal stenosis and granulation.

Materials and Method：A total 13 subjects, of whom 2 had anterior glottic web, 4 posterior laryngeal stenosis, and 7 laryngeal granuloma were included. All underwent stroboscopy and were treated with endoscopic laryngomicrosurgery with CO2 laser. Then, 1 cc of 0.4 mg/mL Mitomycin-C was directly applied for 4 minutes on the surgical site. The patients' symptoms were assessed, and the size of the airway was graded on a scale of I (≤50%) to IV (total occlusion) after a mean follow-up period of 5 months. The recurrence of the laryngeal granuloma was checked.

Results：There was a significant improvement in postoperative symptoms in the group of posterior laryngeal stenosis. Two with tracheotomy underwent decannulation. The postoperative size of airway was markedly increased and restenosis was not noted. There was only one case of recurrence in the granuloma group.

Conclusion：According to these preliminary results, it is suggested that application of Mitomycin-C can be used as a beneficial adjunct therapy in the endoscopic COc laser excision for laryngeal stenosis and granuloma.