Outcome of topical mitomycin in CO2 laser arytenoidectomy

ABSTRACT

Healing problems following CO[2] laser arytenoidectomy include granulation tissue formation into the laryngeal lumen and/or fibrous tissue proliferation with scar contracture, both resulting in postoperative airway stenosis. Thus laryngeal stenosis may develop after arytenoidectomy. Mitomycin topically applied leads to almost complete, irreversible inhibition of fibroblast proliferation. The objective of this study is to investigate whether mitomycin limits granulation tissue formation and allows the healing process to complete without airway stenosis. The study was done on 20 patients with severely impaired airway due to bilateral vocal cords paralysis. Ten patients were treated by CO[2] laser arytenoidectomy followed by immediate topical applications of mitomycin to the ary-cnoidectomy wound. The other 10 patients were treated by CO[2] laser arytenoidectomy without mitomycin application. All patients treated with aryteniodectomy and mitomycin had successful restoration of airway, while the other 10 patients treated by arytenoidectomy had, insufficient airway in two patients and granuloma formation in two other patients. The study showed that topical treatment with low dose mitomycin significantly reduces post CO[2] laser arytenoidctomy wound complications in the from of granulation tissue and fibrosis which may impair the airway