IngentaConnect Effect of mitomycin C on ostium in dacryocystorhinostomy

Authors: Deka, Amarendra; Bhattacharjee, Kasturi; Bhuyan, Saurabh Kr; Barua, Chiranjib Kumar; Bhattacharjee, Harsha; Khaund, Gautom

Source: Clinical & Experimental Ophthalmology, Volume 34, Number 6, August 2006 , pp. 557-561(5)

Publisher: Blackwell Publishing

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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