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79th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

30.04. - 04.05.2008, Bonn

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Intraoperative local application of mitomycin C for prophylaxis of scares and re-stenosis in Otorhinolaryngology

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  • corresponding author Sokratis Trellakis - Department of Otorhinolaryngology, University Duisburg-Essen, Essen, Germany
  • Zeynel Dogan - Department of Otorhinolaryngology, University Duisburg-Essen, Essen, Germany
  • Claus Unkel - Arnsberg-Neheim, Germany
  • Klaus Jahnke - Department of Otorhinolaryngology, University Duisburg-Essen, Essen, Germany
  • Jürgen Lautermann - Department of Otorhinolaryngology, Hospital Martha-Maria, Halle, Germany
  • Stephan Lang - Department of Otorhinolaryngology, University Duisburg-Essen, Essen, Germany
  • Götz Lehnerdt - Department of Otorhinolaryngology, University Duisburg-Essen, Essen, Germany

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. 79th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. Bonn, 30.04.-04.05.2008. Düsseldorf, Köln: German Medical Science; 2008. Doc08hno44

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/hno2008/08hno44.shtml

Published: July 8, 2008

© 2008 Trellakis et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Background: Mitomycin C (MMC) inhibits the proliferation of fibroblasts. Therefore, it has been used successfully for 30 years for prevention of re-stenosis in the surgery of lacrimal duct or glaucoma. In the last years, the use of MMC is also increasing in the prevention of scares in Otorhinolaryngology, e.g. also in the laryngeal and tracheal surgery.

Patients and Methods: In the time from 02/02 to 10/07 MMC was applicated topically during surgery of 38 patients (mean age 56 [2–84] years) as off-label use. In 29 of 38 patients there was the history of an operated malignant tumor. After laser-surgical dissection of the scares, they were swabbed with MMC [2 mg/ml] for 2 minutes. MMC was used in following indications: 16 patients suffered from a glottic stenosis, 15 from a postoperative scarry fixation between tongue and floor of the oral cavity, 3 patients each from a subglottic or tracheal stenosis and one from a keloid.

Results: Observation of the postoperative progress showed a notable and constant improvement of tongue motility in 9 of 15 cases after combination of laser-surgical detaching of the tongue and application of MMC. The 3 cases of subglottic stenosis were also improved significantly after that therapeutical procedure. After glottic application of MMC – mostly anterior synechia after laser-surgical partial laryngectomy – the outcome (endoscopy, stroboscopy, RBH-score) was satisfying in 10 of 16 patients, in 6 – one with laryngeal involvement of Churg-Strauss-syndrome – a re-stenosis was observed after only few weeks.

Discussion: These first results are encouraging, so that a prospective randomized study is initiated to evaluate the value of local application of MMC added or omitted to the laser-surgical therapy.