Question

Drug of choice in laryngeal stenosis is:

• A. Cyclophosphamide
• B. Doxorubicin
• C. Adriamycin
• D. Mitomycin C

Hint:

Stenosis is a scarring problem. Pick the topical antifibroblast agent.

Answer 1

The Correct Option is D

Step 1: Laryngeal or laryngotracheal stenosis is narrowing of the airway from scar tissue and fibrosis, often after intubation, trauma or surgery. The problem is excessive fibroblast proliferation and collagen deposition that re-narrow the airway after dilation.

Step 2: Mitomycin C is an antibiotic derived from Streptomyces that acts as an antifibroblastic and alkylating agent. Applied topically at the stenotic site after endoscopic dilation or laser, it suppresses fibroblast proliferation and reduces scar reformation. This is why it is the drug of choice as an adjunct in airway stenosis.

Step 3: Cyclophosphamide, doxorubicin and adriamycin are systemic cytotoxic chemotherapy agents used for malignancies. Doxorubicin and adriamycin are in fact the same drug. None of them is used topically to control scar formation in laryngeal stenosis.

Step 4: By process of mechanism and clinical use, the correct choice is the topical antifibrotic agent.

Answer: D. Mitomycin C.