Role of Mitomycin-C in Endoscopic Endonasal Dacryocystorhinostomy

Abstract

Vamshi Krishna Rao Koppula, Lingaiah Jadi, Deepak Kumar Phulwani, Boundinika Madhuri Nanduri, Venkata Muni Reddy

BACKGROUND Endoscopic dacryocystorhinostomy (DCR) has certain advantages over the conventional external DCR. Failures in endo DCR are mainly due to reclosure of stoma in the lateral nasal wall. Mitomycin-C is an alkylating, an antiproliferative agent which reduces fibroblast collagen synthesis by inhibiting DNA dependent RNA synthesis and suppresses cellular proliferation when topically applied to mucosal tissues inhibit excessive scar tissue and granulation tissue formation. We wanted to evaluate the role of Mitomycin-C in endoscopic endo nasal DCR as an adjunct. METHODS Our prospective study was performed with 104 patients in 35-75 years age group who presented with chronic dacryocystitis. The study sample was designed randomly into Group A and group B. Group A patients were treated with Mitomycin-C to the incision site and Group B patients were not administered Mitomycin-C. These patients had 6 months of follow up. RESULTS 50 patients out of 52 in Group A had successful surgical outcome. In Group B 48 patients out of 52 were clinically free after the dacryocystorhinostomy. The results obtained had no significant difference between the Group A and Group B. CONCLUSIONS Use of intraoperative mitomycin-C is easy and safe but, in our study, it does not show any significant benefit in surgical outcome of endo DCR in preventing reclosure of stoma site.

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