Prevention of anterior glottic stenosis after transoral microresection of glottic lesions involving the anterior commissure with mitomycin C.
OBJECTIVE
To evaluate the effectiveness of topical mitomycin C (MMC) in preventing anterior glottic stenosis (AGS) after transoral microresection of glottic lesions involving the anterior commissure (AC).


METHODS
Prospective clinical study.


METHODS
Sixteen patients with benign or malignant glottic lesions involving the AC were studied. The lesions were removed by transoral microsurgery using a CO2 laser or cold microinstruments. In all patients, the anterior glottis was treated topically with 0.4 mg/mL MMC for 5 minutes at the end of surgery. The postoperative vocal folds and voice quality of patients were evaluated using video strobolaryngoscopy and voice recordings.


RESULTS
Four patients had local recurrences after surgery and were treated with repeat microsurgery. Postoperatively, five patients (31%) developed acceptable small webs in the anterior glottis; one resolved with web lysis and a second with topical MMC. Postoperative vocal quality was affected mainly by the extent of vocal fold resection and the subsequent wide glottal gaps and extensive scarring, rather than by MMC use per se. Significant local side effects or atrophy of the vocal folds owing to MMC were not found.


CONCLUSIONS
Topical MMC may be useful for preventing AGS and subsequent dysphonia after transoral microresection of glottic lesions involving the AC.
Roh
Jong-Lyel
JL
Department of Otolaryngology-Head and Neck Surgery, Cancer Research Institute, Chungnam National University College of Medicine, Daejeon, South Korea. rohjl@cnu.ac.kr
Yoon
Yeo-Hoon
YH
D000287:Administration, Topical; D000328:Adult; D000368:Aged; D002675:Child, Preschool; D005260:Female; D005931:Glottis / Q000601:surgery*; D006801:Humans; D007829:Laryngostenosis / Q000517:prevention & control*; D007830:Larynx / Q000502:physiology; D053685:Laser Therapy; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage*; D011446:Prospective Studies; D049489:Stroboscopy; D014833:Voice Quality
D016685:Mitomycin