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Updated: May 16, 2026
Transcanalicular Diode Laser-assisted Dacryocystorhinostomy for the Treatment of Primary Acquired Nasolacrimal Duct Obstruction
Published on: October 13, 2017
Effect of mitomycin C on revision endoscopic dacryocystorhinostomy
Mahmut Ozkiriş1, Abdullah Ozkiriş, Sertan Göktaş
1Department of Otolaryngology, Head and Neck Surgery, Bozok University Medical Faculty, Yozgat, Turkey. mozkiris@yahoo.com
Objective:
The objectives of the study were to compare the outcome and success rate of revision endoscopic dacryocystorhinostomy (EN-DCR) with or without use of adjunctive mitomycin C (MMC) in cases with dacryocystorhinostomy (DCR) failure.
Methods:
Thirty-six consecutive adult patients underwent revision EN-DCR. The patients were divided into 2 groups. In group 1 (18 patients), a neurosurgical cottonoid soaked in MMC at 0.5 mg/mL was placed at the osteotomy site for 5 minutes (using canalicular silicone intubation tube). In the other group (18 patients), standard endoscopic dacryocystorhinostomy technique was used without MMC (using canalicular silicone intubation tube). Successful DCR was defined as relief of symptoms (resolution of epiphora and absence of discharge) as demonstrated by saline irrigation at the last postoperative visit.
Results:
The EN-DCR procedure with adjunctive MMC was successful in 16 (88.88%) cases. The mean follow-up was 11.5 months (7-19 months). No significant complications were encountered. In the control group, the EN-DCR was successful in 10 patients (55.55%). The mean follow-up was 12.7 months (6-22 months). The difference between the 2 groups was statistically significant (P < 0.05).
Conclusions:
Recurrent nasolacrimal duct obstruction after primary DCR is mainly due to reclosure of the nasolacrimal stoma and osteotomy site with granulation tissue. Adjunctive use of intraoperative MMC seems to be a safe adjuvant that could help in increasing the success rates of revision EN-DCR surgery.
Insights
Revision endoscopic dacryocystorhinostomy (EN-DCR) using adjunctive mitomycin C (MMC) significantly improves success rates compared to standard EN-DCR. Intraoperative MMC is a safe and effective adjuvant for treating failed dacryocystorhinostomy (DCR) cases.
Area of Science:
- Ophthalmology
- Otorhinolaryngology
Background:
- Dacryocystorhinostomy (DCR) failure, often due to nasolacrimal stoma reclosure, necessitates revision surgery.
- Endoscopic DCR (EN-DCR) is a common approach for revision surgery.
Purpose of the Study:
- To compare the efficacy of revision EN-DCR with and without adjunctive mitomycin C (MMC).
- To evaluate the success rate of revision EN-DCR in patients with prior DCR failure.
Main Methods:
- Thirty-six patients underwent revision EN-DCR, divided into two groups: one with intraoperative MMC (0.5 mg/mL) and a control group without MMC.
- Both groups utilized canalicular silicone intubation tubes.
- Success was defined by symptom resolution (epiphora, discharge) and confirmed by saline irrigation.
Main Results:
- The EN-DCR group with adjunctive MMC achieved an 88.88% success rate (16/18 patients) with a mean follow-up of 11.5 months.
- The control group (without MMC) had a success rate of 55.55% (10/18 patients) with a mean follow-up of 12.7 months.
- The difference in success rates between the groups was statistically significant (P < 0.05), with no major complications reported.
Conclusions:
- Adjunctive intraoperative mitomycin C appears to be a safe and effective method for increasing success rates in revision EN-DCR surgery.
- Preventing stoma and osteotomy site reclosure with granulation tissue is key to successful revision DCR.
