The Effect of Mitomycin C on the Success Rate of Endoscopic Dacryo cystorhinostomy

ABSTRACT

To evaluate the effect of adjunctive use of mitomycin C on endoscopic endonasal dacryocystorhinostomy(DCR), a total of 75 eyes of 66 patients diagnosed with naso-lacrimal duct obstruction were assigned randomly to either a mitomycin C group or a control group.The surgical procedures in both groups were exactly the same, except in the patients of mitomycin C group, a topical 0.2 mg/ml solution of mitomycin was applied to the osteotomy site intraoperatively for 5 minutes. Mean follow-up period was 6.8 months in the mitomycin C group and 7.2 months in the control group. The success rate of endoscopic DCR with intraoperative mitomycin C was 89% whereas the success rate of endoscopic DCR without mitomycin C was 79%. Membranous obstruction, causing failure of surgery occurred in five eyes in the control group while it occurred in two eyes in the mitomyicn C group. Synechia with middle turbinate was found in one eye in the control group, but there was no such synechia found in the patients in the mitomycin C group. Granulation tissue formation also occurred in two eyes in the mitomycin C group as well as in two eyes in the control group. During follow-up period, no complications such as mucosal necrosis, or infection were noted in any patients of mitomycin C group. Adjunctive use of mitomycin C as a wound healing inhibitor is considered to increase the success rate of endoscopic endonasal DCR.