Is mitomycin C useful as an adjuvant therapy in endoscopic treatment of laryngotracheal stenosis?

BACKGROUND Laryngotracheal stenosis has multiple etiologies including external trauma, autoimmune disease, infection, iatrogenic, reflux, and idiopathic. Treatment options include tracheotomy, open resection, as well as endoscopic approaches with or without laser, cold instrument, or dilatation. The conservative and often patient-preferred endoscopic approaches are proven procedures but carry a 40% to 70% risk of restenosis. Adjuvant therapies have been investigated to improve restenosis including mitomycin C (MMC), an antibiotic isolated from Streptomyces caespitosus. MMC acts as a chemotherapeutic alkylating agent with antineoplastic and antifibrinogenetic properties. MMC inhibits DNA and RNA synthesis preventing fibroblast proliferation. MMC has been used successfully in ophthalmology, and even in otolaryngology for dacrocystorhinostomy and endoscopic sinus surgery.