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

Mohammad-Hossein Baradaranfar1, Jalal Khadem, Shokooh Taghipoor Zahir

  • 1Department of Otolaryngology, Head and Neck Surgery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. baradaranf@yahoo.com

Acta Medica Iranica
|June 18, 2011
PubMed

Insights

Mitomycin C (MMC) may reduce nasal adhesions after endoscopic sinus surgery (ESS). This study found fewer adhesions on the MMC-treated side, though results approached statistical significance, warranting further investigation.

Area of Science:

  • Otolaryngology
  • Surgical Innovation
  • Wound Healing Research

Background:

  • Post-surgical adhesions are a common complication following endoscopic sinus surgery (ESS).
  • These adhesions can lead to surgical failure and negatively impact patient outcomes.
  • Mitomycin C (MMC) has emerged as a potential therapeutic agent to mitigate adhesion formation.

Purpose of the Study:

  • To evaluate the efficacy of Mitomycin C (MMC) in minimizing scar tissue and adhesion formation in the nasal mucosa post-ESS.
  • To compare the incidence of adhesions between MMC-treated and saline-treated nasal sites.

Main Methods:

  • A double-blind, randomized clinical trial involving 37 patients with bilateral chronic rhinosinusitis.
  • Following ESS, randomly assigned nasal sides received either MMC-impregnated or saline-impregnated mesh for 5 minutes.
  • Patients underwent diagnostic endoscopy follow-up for at least three months.

Main Results:

  • Postoperative adhesions occurred in 12 (32.4%) patients.
  • A total of 14 adhesions were observed: 4 (10.8%) on the MMC side and 10 (27%) on the control (saline) side.
  • The observed difference in adhesion rates approached statistical significance (P=0.058).

Conclusions:

  • Mitomycin C (MMC) shows potential in reducing adhesions after endoscopic sinus surgery (ESS).
  • Further research with varied MMC dosages, larger sample sizes, and more frequent topical application is recommended to confirm efficacy.

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