Effect of topical Mitomycin C application in the treatment of post-intubation tracheal stenosis.

Objectives: To assess the efficacy of topical Mitomycin C (MMC) in the treatment of post-intubation tracheal stenosis patients and to report on any complications from its use.
Patients and methods: This is a retrospective study in which patients with post-intubation tracheal stenosis who received topical MMC in their management regardless of age and sex were included in the study. All patients had undergone multiple endoscopic dilatation and topical MMC (0.3 mg/mL) application for 2 min Patients who did not show any improvement were scheduled for tracheal resection and anastomosis with application of temporary stent “Montgomery T-tube”. Patients developed granulation tissue, managed with the same concentration and duration of MMC.
Results: 18 patients had multiple endoscopic dilatation plus MMC application, 11 patients (61.1%) showed an improvement in the degree of airway stenosis. The rest seven patients (38.9%) did not shows any improvement. Six of them undergone tracheal resection and anastomosis, while the seventh patient underwent permanent tracheotomy. All the patients developed granulation tissue after resection and anastomosis and Montgomery T-tube application were treated with endoscopic application of MMC and all of them show complete improvement. We did not report any complications or side effects from the use of MMC intraoperatively or during the follow-up period.
Conclusion: Topical MMC (0.3mg/mL) application could be used safely and effectively in patients who showed initial failed response to MMC after endoscopic dilatation and developed granulation tissue after tracheal resection and anastomosis