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Quantifying the Ototoxicity of Mitomycin: Before versus after Myringotomy
Michael Roskies1, Dan Citra, Sam J Daniel
1McGill University, Montreal, Que., Canada.
Summary
Applying mitomycin C (MMC) before myringotomy is safer for the middle ear. This study found MMC application before incision showed no significant ototoxicity, unlike application after incision.
Area of Science:
- Otolaryngology
- Ophthalmology
- Pharmacology
Background:
- Mitomycin C (MMC) is explored to prevent complications from ventilation tube use during myringotomy.
- Standardizing MMC application and determining its safest timing (before vs. after incision) are crucial.
Purpose of the Study:
- To develop a standardized clinical protocol for MMC use in myringotomy.
- To assess the safety of MMC application timing relative to the surgical incision.
Main Methods:
- Auditory brainstem response (ABR) and distortion product otoacoustic emissions (DPOAE) were measured in 9 female chinchillas.
- MMC was applied either before or after the myringotomy incision.
- Auditory function tests were repeated on days 3, 10, and 17.
Main Results:
- The 'after incision' group showed a statistically significant increase in ABR thresholds on day 17 (19.38 ± 8.26), indicating ototoxicity.
- The 'before incision' group did not exhibit significant changes in ABR thresholds (2.00 ± 3.26; p = 0.003).
- No significant changes were observed in DPOAE testing for either group.
Conclusions:
- Mitomycin C demonstrates less ototoxicity to the middle ear when applied prior to myringotomy.
- A standardized clinical approach for MMC use is proposed for future studies in select cases.
- Applying MMC before the incision is recommended for enhanced safety during myringotomy procedures.
