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Topical Mitomycin C in functional endoscopic sinus surgery.

Vaidyanathan Venkatraman1, Deepak Balasubramanian, Suria Gopalakrishnan

  • 1Department of Otolaryngology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.

European Archives of Oto-Rhino-Laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
|December 14, 2011
PubMed
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Topical Mitomycin C reduced post-operative complications like synechiae formation after endoscopic sinus surgery. Early symptom improvement in nasal block and discharge was observed, with fewer adverse tissue reactions in the Mitomycin C group.

Area of Science:

  • Otolaryngology
  • Surgical Innovation
  • Pharmacology

Background:

  • Post-operative complications, such as synechiae, can occur after endoscopic sinus surgery (ESS).
  • Mitomycin C (MMC) has shown potential in reducing scar tissue formation in various surgical fields.
  • The efficacy of topical MMC in ESS requires further investigation.

Purpose of the Study:

  • To evaluate the effectiveness of topical Mitomycin C in reducing post-operative complications following endoscopic sinus surgery.
  • To assess the impact of Mitomycin C on synechiae formation and patient-reported symptoms after ESS.
  • To compare the incidence of adverse tissue reactions between Mitomycin C and saline application in the post-operative period.

Main Methods:

  • A prospective, randomized controlled trial was conducted with 50 patients undergoing ESS for chronic bilateral rhino sinusitis.

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  • Mitomycin C-soaked pledgets were applied to one nasal cavity (test), while saline-soaked pledgets were applied to the contralateral side (control).
  • Patients were assessed for synechiae, symptoms (nasal block, discharge), and adverse tissue reactions at 1 week, 1 month, 3 months, and 6 months post-surgery.

    • Main Results:

    • A statistically significant reduction in synechiae formation was observed on the Mitomycin C side at the first week follow-up.
    • Patients reported significant improvement in nasal block and discharge on the Mitomycin C side compared to the saline side at one week.
    • Fewer adverse tissue reactions, including granulation, discharge, polypoidal mucosa, and crusting, were noted on the Mitomycin C side at one month.

    Conclusions:

    • Topical Mitomycin C effectively reduces immediate post-operative synechiae formation after endoscopic sinus surgery.
    • Early application of Mitomycin C improves patient symptoms of nasal obstruction and discharge.
    • Mitomycin C demonstrates a favorable safety profile with reduced adverse tissue reactions in the early post-operative period.