Refining indications for the use of mitomycin C using a randomized controlled trial with an animal model

OBJECTIVES: To evaluate the effect of mitomycin on the repair of acquired subglottic stenosis and to define the optimal concentration of mitomycin that would minimize restenosis after repair. STUDY DESIGN AND SETTING: A randomized prospective model was used in which 20 ferrets (Mustela putorius furo) underwent simulated intubation injury that was then treated with CO2 laser lysis. RESULTS: Comparison of cross-sectional airway areas, after stenosis repair, showed no significant differences between control and mitomycin treatment groups. Comparison of histologic scores for both inflammation and mucosalization yielded no difference between control and treatment animals. CONCLUSIONS: Mitomycin C appeared to have no benefit when placed after repair of an acquired stenosis. SIGNIFICANCE: This study closely models the injury experienced by children with acquired subglottic stenosis. These data provide clear evidence that mitomycin is limited in its effect on established wounds and help further define its role as an adjuvant for surgery in the aerodigestive tract. (C) 2007 American Academy of Otolaryngology-Head and Neck Surgery. Foundation. All rights reserved.