[Mitomycin C: prevention and treatment of anterior glottic synechia].
OBJECTIVE
Topical applications of mitomycin C to the anterior glottis may prevent anterior glottic synechia (prevention group) or restenosis (treatment group).


METHODS
In the prevention group, six patients with glottic carcinoma involving the anterior commissure were treated by transoral laser surgery. Repeated procedures were performed in one patient. For the six patients in the treatment group, the anterior glottic synechia was secondary to frontolateral laryngectomy (three patients), transoral laser therapy for laryngeal papillomatosis (two patients) or bilateral glottic carcinoma (one patient). Mitomycin C (0.4 mg/ml) was used as a topical application on the anterior commissure for a duration of 4 minutes. Outcome was assessed clinically at three months using a visual scale: no synechia (success), micro-synechia (partial failure), and synechia (failure).


RESULTS
In the prevention group, there were six successes and one partial failure. In the treatment group, there were two successes, three partial failures, and one failure. No side effects were noted.


CONCLUSIONS
Topical application of mitomycin C was effective to prevent anterior glottic synechia after transoral laser surgery for glottic carcinoma involving the anterior commissure. It is an alternative to endolaryngeal keel in patients with sequellar synechia. These preliminary results should be further evaluated in a larger series.
de Monès
E
E
Service d'Oto-Rhino-Laryngologie et de Chirurgie Cervico-Faciale, Hôpital Européen Georges Pompidou, Assistance Publique--Hôpitaux de Paris, Université Paris V, 20, rue Leblanc, 75908 Paris Cedex 15, France.
Lagarde
F
F
Hans
S
S
Ménard
M
M
Laccourreye
O
O
Brasnu
D
D
D000328:Adult; D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use*; D002277:Carcinoma / Q000188:drug therapy* / Q000473:pathology*; D005260:Female; D005931:Glottis / Q000473:pathology*; D006801:Humans; D007822:Laryngeal Neoplasms / Q000188:drug therapy* / Q000473:pathology*; D007829:Laryngostenosis / Q000188:drug therapy* / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000627:therapeutic use*; D010212:Papilloma / Q000188:drug therapy* / Q000473:pathology*
D000903:Antibiotics, Antineoplastic; D016685:Mitomycin