Effect of mitomycin in the surgical treatment of tracheal stenosis

Arch Otolaryngol Head Neck Surg. 2008 Jul;134(7):709-14. doi: 10.1001/archotol.134.7.709.


Objective: To assess the capacity of high and low doses of the antimitotic drug mitomycin to prevent laryngeal stenosis in an animal model.

Methods: A prospective, randomized, double-blind, controlled study was carried out. End-to-end anastomosis was performed in 18 rabbits after tracheal annulus resection to produce inflammation. There were 3 treatment groups: topical saline (isotonic sodium chloride solution) and low-dose (0.2 mg/mL) and high-dose (0.5 mg/mL) topical mitomycin.

Results: A total of 107 procedures were performed: 54 surgical procedures, 35 fibrobronchoscopies, and 18 biopsies. The effect of mitomycin was dose related. In the high-dose mitomycin group, most rabbits progressed to stenosis with a percentage decrease in airway diameter that was significantly greater than in the other 2 groups (P <.001). The mean (SD) percentage of maximum stenosis in the high-dose group was 51% (22%). In the low-dose and saline groups, it was 18% (13%) and 16% (9%), respectively. No significant differences in tracheal stenosis between the low-dose mitomycin and saline groups were observed. Blinded histopathological analysis also showed no significant differences between the saline group and the low-dose mitomycin group. Compared with the other 2 groups, the high-dose mitomycin group had a significant increase in fibroproliferative tissue (P <.001).

Conclusion: These results suggest that topical mitomycin is not effective for avoiding tracheal stenosis and may provoke the opposite effect if the dose is not carefully selected.

MeSH terms

  • Airway Obstruction / pathology
  • Airway Obstruction / prevention & control
  • Anastomosis, Surgical*
  • Animals
  • Antimitotic Agents / pharmacology*
  • Biopsy
  • Bronchoscopy
  • Disease Models, Animal*
  • Dose-Response Relationship, Drug
  • Laryngoscopy
  • Laryngostenosis / pathology
  • Laryngostenosis / prevention & control*
  • Larynx / pathology
  • Larynx / surgery
  • Mitomycin / pharmacology*
  • Postoperative Complications / pathology
  • Postoperative Complications / prevention & control*
  • Prospective Studies
  • Rabbits
  • Trachea / pathology
  • Trachea / surgery*
  • Tracheal Stenosis / pathology
  • Tracheal Stenosis / prevention & control*


  • Antimitotic Agents
  • Mitomycin