A Modified Approach for Preventing Anterior Glottic Web Formation Using Mitomycin C in Bilateral Vocal Fold Lesions

Area of Science:

• Otolaryngology
• Laryngology
• Surgical Innovation

Background:

• Anterior glottic webs can form after vocal fold surgery.
• Existing prevention methods like laryngeal keels or sutures have limitations.

Purpose of the Study:

• To introduce and evaluate a modified surgical approach for preventing anterior glottic webs.
• To assess the efficacy and safety of simultaneous bilateral vocal fold lesion removal with topical mitomycin-C (MMC).

Main Methods:

• Retrospective study of 23 patients undergoing simultaneous bilateral vocal fold lesion removal with topical MMC.
• Second laryngomicroscopic surgery (LMS) with topical MMC was performed if exudate was present after 4-6 weeks.
• Anterior glottic web extent was quantified as a percentage of membranous vocal fold length.

Main Results:

• 18 of 23 patients recovered without anterior glottic webs or fibrin exudate after the initial surgery.
• 5 patients developed thick exudate and underwent a second LMS.
• All patients showed improvement and no anterior glottic web formation after the second LMS.

Conclusions:

• The modified surgical method effectively prevents anterior glottic web formation.
• This approach offers a promising, complication-free alternative for vocal fold surgery patients.
• Simultaneous lesion removal combined with topical MMC and staged intervention appears safe and effective.