Mitomycin-C in Post-endoscopic Septoplasty Synechiae: Does it Really Helps?

Area of Science:

• Otolaryngology
• Surgical Innovation

Background:

• Endoscopic septoplasty offers improved visualization but carries a risk of synechiae (adhesions).
• Submucosal flap tears during septoplasty, particularly with spurectomy, increase adhesion formation.
• Existing methods like splints and packing have limitations in preventing adhesions.

Purpose of the Study:

• To evaluate the efficacy of topical mitomycin-C in preventing post-operative adhesions following endoscopic septoplasty.
• To assess the impact of mitomycin-C on adhesion rates, particularly in cases with submucosal flap tears.

Main Methods:

• Eighty patients undergoing septoplasty with spurectomy were studied.
• Patients with submucosal flap tears were divided into two groups (40 each).
• Group 1 received topical mitomycin-C (0.4 mg/ml) on raw areas for 5 minutes; Group 2 (control) received normal saline.

Main Results:

• The adhesion rate at one month was 17.5% in the mitomycin-C group versus 45% in the control group (P=0.008).
• Mitomycin-C significantly decreased the incidence of post-operative adhesions.
• The benefit was particularly noted in cases with submucosal flap tears or concurrent turbinate reduction.

Conclusions:

• Topical mitomycin-C is effective in reducing post-operative adhesions after endoscopic septoplasty.
• Routine use of mitomycin-C is recommended, especially in challenging septoplasty cases involving flap tears or turbinate surgery.
• Mitomycin-C's antifibroblastic properties inhibit scar tissue formation without impeding healing.