Comparative Study of Endonasal Endoscopic Dacryorhinostomy with or without Intraoperative Mitomycin C

Abstract

Objective: Endoscopic dacryocystorhinostomy (DCR) has known advantages over external DCR as a less invasive method without the need of any skin incision. Mitomycin C (MMC), a wound healing inhibitor, was used intraoperatively with the objective of reducing incidence of adhesion and synechiae formation as a postoperative complication leading to failure of the procedure. Materials and methods:Endoscopic DCR was performed in 60 patients. MMC (0.5 mg/dl for 5 minutes) was applied to the ostium in 30 patients in comparison with control group. Results:The postoperative follow-up was done at 1, 3 weeks and 3 months. The success rate of endoscopic DCR with intraoperative MMC was 90%whereas it was found to be 83.33% in control group. The statistical analysis did not show a difference between the two groups according to success rates. Conclusion:Adjunctive use of a wound healing inhibitor may be considered to increase the success rate of endoscopic DCR. Its intraoperative use seems to be easy and safe. This study of limited series needs further extensive evaluation to establish the adjunctive use of MMC in endoscopic DCR in future.