Management of Pediatric Airway Stenosis using Cold Instruments and Mitomycin-C

Song, Jae Jin; Lim, Yune Sung; Kwon, Seong Keun; Hah, Jeong Hun; Ahn, Soon Hyun; Sung, Myung Whun; Kim, Kwang Hyun

Abstract

BACKGROUND AND OBJECTIVES
Mitomycin-C is becoming one of the most important agents in the treatment of glottic and subglottic stenosis. This study was conducted to investigate the clinical outcome of endoscopic management in glottic and subglottic stenosis patients using cold instruments and Mitomycin-C. SUBJECTS AND METHODS: A total of 47 patients with glottic and subglottic stenosis who were diagnosed and surgically treated in Seoul National University Children's Hospital from Jan. 2000 through Aug. 2003 were included. All were treated for endoscopic laryngomicrosurgery using cold instruments and bougienage. Thereafter, 0.4 mg/ml Mitomycin-C was directly applied for 5minutes on the surgical site. The surgical treatment outcome was retrospectively analyzed by reviewing medical records. RESULTS: All the studied patients showed improved airway stenosis and subjective symptoms, and twenty-one out of 47 patients have been decannulated successfully without any special complications. Mean number of operation for decannulation was 5.1, and the mean duration from the initial operation to decannulation was 17.3 months. CONCLUSION: Our data suggest that the use of cold instrumentation and topical mitomycin-C application might be a promising, initial choice of management in patients with airway stenosis.