Significance of adjunctive mitomycin C in endoscopic dacryocystorhinostomy

• Published in: American journal of otolaryngology 2012, Vol.33 (1), p.47-50
• Main Authors: Prasannaraj, Thomas, MS, Kumar, B.Y. Praveen, DLO, Narasimhan, Indira, MS, Shivaprakash, K.V., DLO
• Format: Article
• Language: English
• Subjects: Administration, Topical; Adolescent; Adult; Alkylating Agents - administration & dosage; Biological and medical sciences; Combined Modality Therapy; Dacryocystitis - drug therapy; Dacryocystitis - surgery; Dacryocystorhinostomy - methods; Endoscopy - methods; Female; Head and neck surgery. Maxillofacial surgery. Dental surgery. Orthodontics; Humans; Intraoperative Period; Male; Medical sciences; Middle Aged; Mitomycin - administration & dosage; Ostomy; Otolaryngology; Otorhinolaryngology. Stomatology; Prospective Studies; Single-Blind Method; Studies; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgical techniques; Treatment Outcome
• ISSN: 0196-0709; 1532-818X
• DOI: 10.1016/j.amjoto.2011.01.001

Abstract Purpose The purpose of this study is to observe the effect of intraoperative topical application of mitomycin C (MMC) on the results of endoscopic dacryocystorhinostomy. Design This is a prospective, randomized, controlled, single-blind study. Settings Hospitalized treatment was done in a tertiary medical college hospital and research center that deals with a predominantly rural population. Patients Patients with primary acquired postsaccal obstruction causing chronic dacryocystitis were considered. Methods A total of 38 patients were randomized into either a mitomycin group or a control group. Both of these groups were subjected to an identical surgical procedure, except that 0.2 mg/dL of MMC was used in the mitomycin group, whereas normal saline was used in the control group. The follow-up period was at least 6 months. An asymptomatic patient with a visible stoma at nasendoscopy and free flow of saline into the nose with lacrimal syringing after 6 months after surgery was used as criteria for defining a successful result. Results The success rate was 82.3% when MMC was used and 85.7% among the controls ( P > .05). Granulations, adhesions, and obliterative sclerosis occurred in a similar number of patients of both groups. However, granulations and adhesions did not have a bearing on the success rate in either group. Conclusion Mitomycin C did not appear to influence the occurrence of granulations, synechiae, or obliterative sclerosis, nor did it alter the success rate significantly.