Prevention of adhesion after endoscopic sinus surgery: role of mitomycin C

Adhesions after endoscopic sinus surgery [ESS] are a potential cause of surgical failure. Mitomycin-C [MMC] is recently proposed as a solution for these adhesions. This study was performed to investigate the effect of Mitomycin C in reducing scar formation and adhesion in the nasal mucosa after endoscopic nasal surgery. This double blind randomized clinical trial study was performed on 37 patients with bilateral chronic rhinosinusitis. At the end of ESS, randomly impregnated mesh with MMC was placed in one side and another mesh impregnated with saline in the opposite side for 5 minutes. Patients were followed at least for three months, and the results of diagnostic endoscopy were recorded. Post operative adhesion occurred in 12 [32.4%] patients [2 bilateral/10 unilateral]. Among total of 14 adhesions, 4 [10.8%] were in the MMC side and 10 [27%] in the control side. This differences was close to statistically significant [P=0.058]. MMC may reduce adhesions after ESS, but further studies with different doses, sample size and frequent use of topical MMC is recommended

Hearing status in neonatal hyperbilirubinemia by auditory brain stem evoked response and transient evoked otoacoustic emission

Hyperbilirubinemia at neonatal period is one of the major deteriorating factors of the auditory system. If left untreated, it may cause certain cerebral damage. This study aims to evaluate the impact of hyperbilirubinemia on the hearing of neonate. This study was conducted on 35 newborn babies with jaundice [bilirubin more than 20 mg/dL]. Auditory brainstem response [ABR] and transient evoked otoacoustic emission [TEOAE] tests were performed, after treatment and one year after. ABR test results indicated that 26 children [74.3%] had normal hearing but 9 [25.7%] suffered from an impairment. As for TEOAE test, 30 children [85.7%] passed whereas the remaining [14.3%] seemed to be failures. The comparative results of the two tests pointed to autonomic neuropathy /autonomic dysreflexia symptoms in 5 babies. Due to the high incidence of Autonomic neuropathy/autonomic dysreflexia among hyperbilirubinemic babies, screening in this regard seems reasonable. Our result emphasizes the necessity of more experiments on the afflicted areas