Role of Mitomycin-C in Otorhinolaryngology Surgical Procedures: A Review

Introduction: Different surgical procedures in otorhinolaryngology are done to address the narrowing of upper aerodigestive path in case of stenosis or stricture. The postoperative complications, such as scarring or stenosis, can occur in the upper airway and oesophagus. The alkylating antineoplastic antibiotic mitomycin-C (MMC), which is an aminoglycoside is an additional treatment option to prevent scarring or stenosis. Methods: A comprehensive review of literature from databases such as Scopus, PubMed, Medline, and Google Scholar was conducted to analyse the role of MMC in otorhinolaryngological surgical procedures. Results: The stricture or stenosis of the upper aerodigestive tract can result in significant morbidity and often pose challenge in life. Endoscopic airway dilation for treating laryngotracheal stenosis can provide short-term improvement, but it is often associated with long-term recurrence. Recently, the use of MMC has been investigated as an additional treatment to help reduce scar tissue formation. Conclusion: MMC regulates wound healing and inhibits scarring or stenosis formation by preventing fibroblast proliferation and the production of extracellular matrix proteins. MMC application has been shown to be safe in animal and human studies. It has been proposed that applying MMC during endoscopic dilatation and laser surgery can improve the results, however, this has not been thoroughly investigated.