Office-based retrograde transtracheal application of mitomycin C

Area of Science:

• Otolaryngology
• Surgical Innovation
• Pharmacological Adjuncts

Background:

• Topical mitomycin C (MMC) is used for laryngeal and tracheal stenosis.
• Optimal timing for MMC application post-surgery remains unclear.
• Limited studies evaluate MMC timing after airway interventions.

Purpose of the Study:

• Describe a novel technique for delayed MMC application.
• Facilitate office-based, unsedated MMC administration.
• Investigate MMC use approximately one week after endoscopic airway dilation.

Main Methods:

• Developed a retrograde transtracheal MMC application technique.
• Utilized in 3 tracheostomy-dependent patients with subglottic/glottic stenosis.
• Applied MMC (0.4 mg/ml) via a transtracheal approach under topical anesthesia.

Main Results:

• Successful in-office retrograde MMC application in all 3 patients.
• Application occurred 7-9 days post-surgery without complications.
• Two patients were successfully decannulated.

Conclusions:

• Novel, well-tolerated technique for delayed, in-office MMC application.
• Applicable to tracheostomy-dependent patients with laryngeal stenosis.
• Supports further research into ideal MMC timing for airway stenosis.