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Can mitomycin C really prevent airway stenosis?
Jong-Lyel Roh1, Yong-Won Lee, Chan Il Park
1Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. happyfam@paran.com
Background/Objectives:
Mitomycin C (MMC) is used in the prevention of upper airway stenosis. However, the efficacy of MMC is still debatable, and the potential complications of MMC use have been scarcely reported. We evaluated the efficacy and early complications of MMC in a wound model of the subglottis.
Study Design:
A randomized animal study.
Methods:
Sixty rabbits underwent a full-thickness injury to the posterior subglottis by diode laser. The animals were randomly assigned to three groups according to the different topical treatments of MMC 0.4 or 10 mg/mL or saline alone for 5 minutes. Animals were killed at 4 weeks, and gross and histologic findings were compared among different groups and 10 age-matched, non-wound, normal controls.
Results:
Thirty-two of the 60 (53%) animals died mainly of acute airway obstruction by necrotic debris, sloughs on, or cartilage collapse of the unhealed posterior subglottis during early weeks after wounding, higher in the MMC-treated animals (67%) than in the wound controls (25%) (P = .007). This resulted from the significant delay of wound healing in the MMC-treated groups compared with the wound controls (P = .012). The degree of subglottic stenosis was comparable among different groups (P > .8), although collagen deposition was significantly lower in the MMC-treated groups compared with the untreated controls (P = .036).
Conclusions:
There was a significant risk of acute airway obstruction from delayed wound healing in rabbits that received subglottic laser wounding and MMC treatment. This risk should be considered in the use of MMC in clinical practice.
Insights
Mitomycin C (MMC) treatment for subglottic stenosis in rabbits delayed wound healing and increased airway obstruction risk. The study suggests caution when using MMC clinically due to these complications.
Area of Science:
- Otolaryngology
- Regenerative Medicine
- Surgical Innovation
Background:
- Mitomycin C (MMC) is utilized to prevent upper airway stenosis.
- Its clinical efficacy remains debated, with limited data on complications.
- Subglottic stenosis presents a significant clinical challenge.
Purpose of the Study:
- To evaluate the efficacy and early complications of Mitomycin C (MMC) in a rabbit subglottic wound model.
- To assess the impact of MMC on wound healing and stenosis development.
Main Methods:
- A randomized animal study involving 60 rabbits with laser-induced subglottic injury.
- Animals were treated with topical Mitomycin C (MMC) at 0.4 or 10 mg/mL, or saline.
- Outcomes were assessed at 4 weeks, comparing wound healing, stenosis, and complications.
Main Results:
- A higher mortality rate (67%) was observed in MMC-treated groups due to airway obstruction, compared to controls (25%).
- Mitomycin C (MMC) significantly delayed subglottic wound healing.
- The degree of stenosis was similar across groups, but collagen deposition was reduced with MMC.
Conclusions:
- Subglottic laser wounding combined with Mitomycin C (MMC) treatment carries a significant risk of acute airway obstruction.
- Delayed wound healing is a key complication associated with MMC use in this model.
- Clinical application of MMC for subglottic stenosis warrants careful consideration of these risks.
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