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Mitomycin C is part of the mitomycin group of antibiotics and has found use in medicine in the treatment of various cancers, including those of the head and neck. In recent years, it has gained popularity as a topical treatment to prevent scar formation in the larynx and choanae in paediatric and adult inflammatory processes. Also, this alkylating agent is potentially a potent carcinogen. We report the first case in the world literature of laryngeal carcinoma in a non-smoking adult, which may have been induced by topical mitomycin C application to a glottic web. We discuss the mechanism of action of this drug, and we advise caution on its use for benign laryngeal pathologies.

OBJECTIVE: 1. To understand the risk and possible mechanism of thermal injury to the tongue during suspension laryngoscopy. 2. To detail the nature of thermal injury from laryngoscopy based on an experimental paradigm. METHODS: Following a cluster of cases in 2005 during which tongue injury was noted following laryngoscopy, the cause was sought out. Case specifics such as operative time, light source, and the nature of the procedure were reviewed from medical records. To further detail the nature of thermal injury, a prospective study was undertaken by exposing roomtemperature fresh meat to laryngoscopy. Tissue heating was recorded over time at fixed distances from the light carrier contact spot. Comparisons were made between the new and old light sources. RESULTS: The common element in the injuries was the introduction of a new make of light source in the operating room. In comparing the new to the old light sources, laryngoscopy with the new brand resulted in tissue heating by 20 degrees F before plateauing at 90 minutes. The tissue heating occurred out to 2 cm from the tip of the light carrier, though this only raised the temperature by 8 degrees F at that distance. The previous brand did not raise tissue temperature even after 90 minutes. CONCLUSIONS: Tissue heating may occur from heated light carriers in operative laryngoscopes. Temperatures in the tongue may increase by 20 degrees F during a 90-minute case. Communication and education of all involved personnel should follow equipment change in the operating room.

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