ABSTRACT
OBJECTIVES: The aim of this study is to investigate the efficacy of topical application of mitomycin C after dilation in pediatric patients having post corrosive esophageal stricture. METHODS: Thirty patients with post corrosive esophageal strictures were divided into two groups: 12 patients had repeated esophageal dilation without mitomycin C application, 18 patients had repeated esophageal dilation and topical application of mitomycin C. RESULTS: There was a highly significant difference in the improvement of dysphagia grade at the end of follow up in the mitomycin C group (p=0.005). The number of repetition of dilatation ranged from 2 to 6 (median=3) in the 1st group, and 2 to 4 (median=2.5) in the mitomycin C group. There were no adverse effects from the topical application of the mitomycin C. CONCLUSIONS: Topical application of mitomycin C after oesophageal dilation can be beneficial in improving dysphagia in patients with post corrosive oesophageal stricture.
Subject(s)
Antibiotics, Antineoplastic/therapeutic use , Burns, Chemical/complications , Dilatation , Esophageal Stenosis/therapy , Mitomycin/therapeutic use , Administration, Topical , Caustics , Child , Child, Preschool , Deglutition Disorders/etiology , Deglutition Disorders/therapy , Esophageal Stenosis/etiology , Esophagoscopy , Female , Humans , Male , Prospective Studies , Severity of Illness IndexABSTRACT
BACKGROUND: The purpose of this study was to investigate the role of intraoperative application of mitomycin C in prevention of glottic restenosis after posterior transverse CO2 laser cordotomy (PTLC) for patients with post-thyroidectomy bilateral vocal fold paralysis. METHODS: Twenty-five patients with an impaired airway because of bilateral vocal fold paralysis were treated with PTLC. Patients were divided into groups: the mitomycin C group (13 patients) had PTLC and topical mitomycin C; and the control group (12 patients) had PTLC only. RESULTS: No patients in the mitomycin C group developed glottic granulation or laryngeal scarring, whereas 5 of 12 patients in the control group developed granulation (p = .014) and 2 of 12 patients had laryngeal scarring (p = .28). Ten of 13 patients in the mitomycin C group ended up with mild dyspnea with no limitation to normal everyday activities whereas only a third of the control group achieved this outcome (p = .05). CONCLUSION: The use of topical mitomycin C has been shown to decrease postoperative laryngeal granulation, scarring, restenosis, and the need for revision surgery.
Subject(s)
Alkylating Agents/administration & dosage , Intraoperative Care , Laryngostenosis/prevention & control , Laser Therapy , Mitomycin/administration & dosage , Vocal Cord Paralysis/surgery , Adult , Cicatrix/prevention & control , Female , Humans , Lasers, Gas/therapeutic use , Male , Middle Aged , Prospective Studies , Recurrence , Wound HealingABSTRACT
OBJECTIVE: This study aimed to assess the virtue of adding prokinetics to proton pump inhibitors (PPIs) in the treatment of laryngopharyngeal reflux (LPR) with regard to symptom and sign improvement and reduction in recurrence rates after cessation of treatment. PATIENTS AND METHODOLOGY: One hundred patients were divided by blind random card selection into two groups, 50 per group. The first group received itopride, a prokinetic agent, with a PPI, and the second group received a PPI and a placebo, both for a period of 8 weeks. They were followed up on a monthly basis for 16 weeks, with documentation of the symptom and sign scores with each visit and with photographic documentation. RESULTS: Eighty-seven patients completed the study. The results showed significant improvement in group A when compared to group B with regard to improvement rates and degrees of subjective and objective improvement, with significantly less recurrence of symptoms. CONCLUSION: Adding prokinetics to PPIs in the treatment of LPR improves the outcome, shortens the need for oral medication, and reduces the rates of recurrence of symptoms.
