[Adjuvants in operative laryngology: corticosteroids, fibrin adhesives, Mitomycin C].
Medicinal adjuvants are often used in operative laryngology but their value is judged very differently. The scientific evidence is unsatisfactory for most of these substances. For corticosteroids it is proven that in pediatric intensive care they reduce stridor following extubation. Routine prophylactic use for intubation does not seem to be justified and methylprednisolone and dexamethasone are the preferred preparations. Fibrin adhesives are well tolerated and low in side-effects. The indications for their use should be primarily limited due to the cost factor. Their use in laryngology remains a decision on an individual case-to-case basis. Mitomycin C is used because of its antiproliferative effect on fibroblasts in order to reduce scar tissue formation. Many positive effects have been attributed to the topical application but there are large differences in dosage and exposure time.
Sittel
C
C
Klinik für Hals-, Nasen-, Ohrenkrankheiten, Plastische Operationen, Klinikum Stuttgart - Katharinenhospital, Stuttgart, Germany. c.sittel@klinikum-stuttgart.de
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant / Q000379:methods*; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use*; D006801:Humans; D007818:Laryngeal Diseases / Q000628:therapy*; D007825:Laryngectomy / Q000639:trends*; D016685:Mitomycin / Q000627:therapeutic use*; D019384:Nucleic Acid Synthesis Inhibitors / Q000627:therapeutic use; D019736:Prostheses and Implants / Q000639:trends*; D014014:Tissue Adhesives / Q000627:therapeutic use
D000305:Adrenal Cortex Hormones; D015718:Fibrin Tissue Adhesive; D019384:Nucleic Acid Synthesis Inhibitors; D014014:Tissue Adhesives; D016685:Mitomycin