Effect of mitomycin C on ostium in dacryocystorhinostomy

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Abstract

Background

To observe the effect of intraoperative mitomycin C of varying concentration on postoperative ostium size after external dacryocystorhinostomy (DCR).

Methods

In this prospective controlled study, 60 cases of DCR were taken up irrespective of age and sex. Cases were divided into three groups. Group 1 was taken as a control group and operated without mitomycin C; in experimental group 2 and group 3, mitomycin C at a concentration of 0.05 mg/mL and 0.4 mg/mL was applied, respectively, for 2 min. Each group consisted of 20 cases. Half of the cases in each group underwent single-flap DCR (SFDCR) and half underwent double-flap DCR (DFDCR) surgery. Nasal endoscopic evaluation was performed on the first postoperative day, at 2 weeks and at 6 months after surgery. A Student's t-test was used to compare the osteotomy size of each group.

Results

At the end of the final follow up, average size of the ostium in group 1 was 3.6 ± 2.36 mm2 in SFDCR and 4.5 ± 3.59 mm2 in DFDCR, in group 2 was 4.8 ± 4.82 mm2 in SFDCR and 4.9 ± 4.12 mm2 in DFDCR, and in group 3 was 16.6 ± 6.80 mm2 in SFDCR and 17.5 ± 9.07 mm2 in DFDCR. The ostium size in group 3 was found to be significantly bigger in comparison with group 1 (P = 0.0001 in SFDCR, P = 0.001 in DFDCR) and with group 2 (P = 0.0009 in SFDCR, P = 0.001 in DFDCR). No statistically significant difference of ostium size was found in SFDCR and DFDCR.

Conclusion

Mitomycin C in appropriate dose minimizes postoperative fibrosis and granulations, thereby maintaining a bigger postoperative ostium throughout the postoperative observation period.

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