Use of local mitomycin C in enhancing laryngeal healing after laser cordotomy: a prospective controlled study.

BACKGROUND The purpose of this study was to investigate the role of intraoperative application of mitomycin C in prevention of glottic restenosis after posterior transverse CO2 laser cordotomy (PTLC) for patients with post-thyroidectomy bilateral vocal fold paralysis. METHODS Twenty-five patients with an impaired airway because of bilateral vocal fold paralysis were treated with PTLC. Patients were divided into groups: the mitomycin C group (13 patients) had PTLC and topical mitomycin C; and the control group (12 patients) had PTLC only. RESULTS No patients in the mitomycin C group developed glottic granulation or laryngeal scarring, whereas 5 of 12 patients in the control group developed granulation (p = .014) and 2 of 12 patients had laryngeal scarring (p = .28). Ten of 13 patients in the mitomycin C group ended up with mild dyspnea with no limitation to normal everyday activities whereas only a third of the control group achieved this outcome (p = .05). CONCLUSION The use of topical mitomycin C has been shown to decrease postoperative laryngeal granulation, scarring, restenosis, and the need for revision surgery.