[The topical application of mitomycin C in the treatment of scar formation and stenosis in hollow organs of the head and neck: a field report].
BACKGROUND
The antibiotic und antitumoral effect of Mitomycin C (MMC), a derivative of Streptomyces caespitosus, has been known since 1956. Besides its use as an adjunction in the treatment of breast, lung and prostate cancer, or as a second-line cytostatic drug for head and neck squamous cell carcinoma (HNSCC), since 1963, MMC has also been successfully used in the suppression of post-operative scar formation, particularly in the field of ophthalmology. This is due to its modulation of fibroblast activity, which enables decreased scarring and fibrosis. In this résumé, we wish to recapitulate our long years of experience in the topical application of Mitomycin C in the treatment of scar formation and stenosis in head and neck organs.


METHODS
A retrospective analysis on the basis of clinical disease courses and findings (image documentation, questionnaires, pulmonary function tests) covering an examination period of 10 years, was performed on 40 patients with stenosising lesions and a mean age of 54 years. The fields of application included laryngeal, tracheal, oesophageal stenosis and stenosis of the external ear canal and the choane.


RESULTS
After combined application of MMC and surgical intervention in cases of recurrent stenosising processes in head and neck organs, especially the larynx and the trachea, a sustained improvement was achieved in the pre-operative stenosis level as well as in the pre-operative, severely limited, forced inspiratory volume in 1 second (F1V1).


CONCLUSIONS
The topical application of MMC appears to be an effective adjunction as a concept of treatment for stenosising, scar-forming lesions. This topical application, however, is not a substitute for correct diagnosis and appropriate surgical treatment. It must be regarded as a purely adjunctive manoeuvre. During the 10 years in which it was used, the clinical findings confirmed an enhancement in the containment of complex cases without the occurrence of any complications.
Bast
F
F
Klinik für Hals-, Nasen-, Ohrenkrankheiten, Universitätsmedizin Berlin, Charité Campus Mitte.
Risteska
K
K
Jovanovic
S
S
Sedlmaier
B
B
D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000402:Airway Obstruction / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage* / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D002921:Cicatrix / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007320:Inspiratory Capacity / Q000187:drug effects; D007828:Laryngoscopy; D007829:Laryngostenosis / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage* / Q000009:adverse effects; D011183:Postoperative Complications / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery; D012008:Recurrence; D012086:Reoperation; D019233:Retreatment; D012189:Retrospective Studies; D014135:Tracheal Stenosis / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery
D000903:Antibiotics, Antineoplastic; D016685:Mitomycin