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Mitomycin C for the Treatment of Pharyngoesophageal Stricture After Total Laryngopharyngectomy and Microvascular Free Tissue Reconstruction
Author(s) -
Annino Donald J.,
Goguen Laura A.
Publication year - 2003
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1097/00005537-200309000-00015
Subject(s) - medicine , surgery , swallowing , mitomycin c , free flap
Objectives To assess the role of mitomycin C (MMC) in the management of pharyngoesophageal stricture after total laryngopharyngectomy and free flap reconstruction. Study Design Five patients since 1998 underwent evaluation and treatment for pharyngoesophageal stricture after total laryngopharyngectomy and free flap reconstruction. The method of reconstruction included four tubed radial forearm free flaps and one jejunal free flap. All patients underwent barium swallow, computed tomography, and endoscopic examination and were proven to be free of recurrent disease. Methods The patients were taken to the operating room. After dilation, the stenotic segment was exposed, and 1 mL of 0.4 mg/mL mitomycin‐C was applied for 4 minutes using a cotton pledget. The patients were then followed clinically and with barium swallows for a minimum follow‐up period of 18 months. Results All five patients experienced improved swallowing ability. The need for further dilatations was either eliminated or lessened. All patients were happy with the treatment results. No complications occurred. Conclusions This small case series suggests that MMC is a safe and effective adjunctive treatment for pharyngoesophageal stricture after total laryngopharyngectomy and free flap reconstruction.