Author(s): Anil Harugop1 , Shailaja M. Hugar2 , Hina Baxi3 , Abhishek Sahu4 , Dharmishtha Kaku5
OBJECTIVE: To determine whether topical application of Mitomycin-C at the conclusion of FESS decreases the incidence of postoperative adhesion formation. STUDY DESIGN: Prospective hospital based interventional study. MATERIALS AND METHODS: Between June 2011-June 2013, 42 patients (65 sides) aged between 16-66 years diagnosed to have chronic rhinosinusitis (CRS) underwent FESS. At the conclusion of the ESS, cotton ribbon wick soaked with 1 ml Mitomycin-C (0.4 mg/ml) was placed in right/left/ both middle meati, near the widened sinus ostia for a period of 4mins. Following application, nasal cavity was irrigated with sterile normal saline. Patients were examined weekly for 1 month after surgery. Additional examinations were done at the end of 2nd and 3rd month post-operatively. At the end of 3 months follow up the outcome was assessed subjectively by symptoms and objectively by endoscopic findings. RESULTS: At the end of 3 months follow up a significant decrease (80%) in symptom scores was observed (6.64± 1.80, p<0.001). Similarly in Sino-nasal outcome test (SNOT) score we observed a significant reduction (71%) in scores (17.76± 8.17, p<0.001) and 3.1% cases showed adhesions. CONCLUSIONS: CRS patients have remarkable improvement in their symptoms after FESS. Topical application of Mitomycin-C at the conclusion of FESS/ESS has a role in prevention of adhesion formation.