Topical endotracheal mitomycin C as a complementary treatment for endoscopic treatment of recurrent laryngotracheal stenosis

Cortés de Miguel, S.; Cabeza Barrera, J.; Gallardo Medina, M.; Cassini Gómez de Cádiz, L.F.; Salmerón-García, A.; Rodríguez Lucas, F.

doi:10.1016/S2173-5085(11)70006-5

Farmacia Hospitalaria

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We established a concentration of 0.4mg/ml topical mitomycin C for the treatment of laryngotracheal stenosis. In the treated cases, we applied a 0.4mg/ml solution to the wound site following laser surgery and dilatation with bronchoscope. Three patients remain asymptomatic from a respiratory perspective, and treatment failed in one case.

Conclusions

LTS treatment is complex due to the continuous development of granulation tissue and fibrosis following injury to the airways. Topical mitomycin C seems to be the ideal adjuvant agent thanks to its powerful antifibrotic effects.

Keywords:

Laryngotracheal stenosis

Endoscopic treatment

Topical Mitomycin C

Resumen

Objetivo

Describir la preparación de mitomicina C tópica endotraqueal y los resultados clínicos de 4 pacientes tratados de forma coadyuvante con mitomicina C tópica para estenosis laringotraqueales (ELT) graves y recurrentes.

Método

Revisión bibliográfica para determinar la concentración y forma de elaboración de mitomicina C para uso tópico endotraqueal. Revisión de las historias clínicas.

Resultados

Se determina una concentración de 0,4mg/ml mitomicina C tópica en el tratamiento de las estenosis laringotraqueales. En los casos tratados se aplicó la solución de 0,4mg/ml en la zona estenosada tras fotorresección con láser y dilatación con broncoscopio. Tres pacientes se encuentran asintomáticos desde el punto de vista respiratorio y en uno, ha fracasado el tratamiento.

Conclusiones

El tratamiento ELT es complejo debido al continuo desarrollo de tejido de granulación y fibrosis como consecuencia de lesiones de la vía aérea. La mitomicina C tópica, por sus potentes efectos antifibróticos, parece ser el agente coadyuvante idóneo.

Palabras clave:

Estenosis laringotraqueal

Tratamiento endoscópico

Mitomicina C tópica

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References

[1.]

Endoscopía Respiratoria y láser,

[2.]

Neumología intervencionista,

[3.]

I. Perepelitsyn, S.M. Shapshay.