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CC BY-NC-ND 4.0 · Int Arch Otorhinolaryngol 2020; 24(01): e112-e124
DOI: 10.1055/s-0039-1700582
Systematic Review
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Mitomycin C in the Endoscopic Treatment of Laryngotracheal Stenosis: Systematic Review and Proportional Meta-Analysis

Thereza L. O. Queiroga
1   Department of Otorhinolaryngology and Head and Neck Surgery, Faculdade de Ciências Médicas e Biológicas de Botucatu, Universidade Estadual Paulista, Botucatu, São Paulo, Brazil
,
Daniele C. Cataneo
2   Department of Surgery, Faculdade de Ciências Médicas e Biológicas de Botucatu, Universidade Estadual Paulista, Botucatu, São Paulo, Brazil
,
Regina H. G. Martins 
1   Department of Otorhinolaryngology and Head and Neck Surgery, Faculdade de Ciências Médicas e Biológicas de Botucatu, Universidade Estadual Paulista, Botucatu, São Paulo, Brazil
,
Tarcisio A. Reis
2   Department of Surgery, Faculdade de Ciências Médicas e Biológicas de Botucatu, Universidade Estadual Paulista, Botucatu, São Paulo, Brazil
,
Antônio J. M. Cataneo
2   Department of Surgery, Faculdade de Ciências Médicas e Biológicas de Botucatu, Universidade Estadual Paulista, Botucatu, São Paulo, Brazil
› Author Affiliations
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Publication History

28 March 2019

10 September 2019

Publication Date:
20 December 2019 (online)

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Abstract

Introduction Mitomycin C is a natural antibiotic that has been used to inhibit the proliferation of fibroblasts in scar tissue.

Objective To evaluate the effectiveness and safety of topical Mitomycin C as an adjuvant in the endoscopic treatment of laryngotracheal stenoses.

Data synthesis A systematic review of experimental or observational studies that have evaluated the treatment of laryngotracheal stenoses with the use of topical Mitomycin C was performed. Databases researched: LILACS, PubMed, Embase, Cochrane and Web of Science. Outcomes: resolution (symptom-free time ≥ one year), number of procedures required, and complications resulting from the procedure. A total of 15 studies (involving 387 patients) were selected. Mitomycin C was administered to every patient in 11 studies, and in 4 other studies, the patients were separated into 2 groups, 1 receiving mitomycin C, and the other not. The resolution of the stenosis evaluated in 12 studies in which the patients received mitomycin C was of 69% (95% confidence interval [95%CI]: 61–76%; I2 = 17.3%). A total of 52% of the patients (95%CI: 39–64%, 11 studies; I2 = 64.7%) were submitted to a single endoscopic procedure, and 48% (95%CI: 36–61%, 11 studies; I2 = 64.7%) were submitted to more than 1 procedure. Complications (mediastinal and subcutaneous emphysema, dysphonia, laceration or vocal fold paralysis and acute light obstruction) were reported in 9% of the patients (95%CI: 3–18%, 9 studies; I2 = 79.8%).

Conclusions The evidence suggests that mitomycin C is an effective and safe option in the endoscopic treatment of laryngotracheal stenosis.

Keywords

laryngotracheal stenosis - mitomycin C - systematic review - dilation - endoscopic treatment