Results of the Application of Intraoperative Mitomycin C in Dacryocystorhinostomy

Roozitalab, Mohammad Hossein; Amirahmadi, Mousa; Namazi, Mohammad Reza

doi:10.1177/112067210401400602

Cited by 53 publications

(37 citation statements)

References 7 publications

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“…Compared with the single-stent group, no significant complications appeared, which was consistent with previous reports [11][12][13][14][15]. The other treatment methods implicated for canalicular obstruction are DCR combined with membranectomy [5,6], trephination and silicone tube stenting [7,16], ballooning with/without silicone stenting [17,18], ballooning canaliculoplasty following lacrimal trephination [8], and intraoperative use of mitomycin C [9,10]. The success rates of these procedures vary in the range of 25-92% with the majority being under 50-60% (Table 7).…”

Section: Discussionsupporting

confidence: 85%

“…For canalicular obstruction, the cause of failure is restenosis or sticky adhesive changes of the canaliculus following the removal of the silicone tube [5][6][7][8][9][10]. We reasoned that the insertion of a wider stent would make the canalicular pathway more patent and aid in maintaining the clearance of the pathway following removal of the tube.…”

Section: Introductionmentioning

confidence: 94%

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Bicanalicular double silicone stenting in endoscopic dacryocystorhinostomy with lacrimal trephination in distal or common canalicular obstruction

Paik

Cho

Yang

2011

Eur Arch Otorhinolaryngol

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The purpose of the study was to evaluate the clinical effects of bicanalicular double silicone stents in endoscopic transnasal dacryocystorhinostomy with lacrimal trephinized canaliculoplasty for monocanalicular and common canalicular obstruction. Bicanalicular double silicone intubation in endoscopic transnasal dacryocystorhinostomy with lacrimal trephination was performed in 58 eyes of 54 patients (5 men, 49 women; mean age: 55.9 ± 14.9 years) with epiphora due to monocanalicular and common canalicular obstruction between November 2007 and August 2010. We reviewed the records of subjects who had undergone the same surgery with a bicanalicular single intubation for same disease between March 2004 and October 2007 as controls (56 eyes of 50 patients). We evaluated age, gender, the operative side, the site of canalicular obstruction, and the effects of double silicone intubation. Complications relating to the silicone tube were also investigated. The double-stent group showed higher anatomical success rates (91.4%) and functional success rates (82.8%) than the single-stent group (75.0 and 69.6%, respectively) (p = 0.034 and p = 0.103, respectively). Bicanalicular double silicone stenting in endoscopic transnasal dacryocystorhinostomy with lacrimal trephinized canaliculoplasty may be an effective treatment for monocanalicular and common canalicular obstructions. This may also reduce more invasive surgery including Jones tube insertion (p = 0.038).

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Section: Discussionsupporting

confidence: 85%

Section: Introductionmentioning

confidence: 94%

Bicanalicular double silicone stenting in endoscopic dacryocystorhinostomy with lacrimal trephination in distal or common canalicular obstruction

Paik

Cho

Yang

2011

Eur Arch Otorhinolaryngol

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“…However, limitations have been reported for both of them, including the potential of silicone intubation to induce an [18][19][20] and the inhibitory effect of MMC on fibroblasts, which potentially limits the regeneration of healthy epithelium. 27,28 Therefore, the ideal agent should promote healthy re-epithelialization without excessive scarring, to ensure ostial patency in DCR. P-values of the rates of failure resulted from the scar and granulation formation were evaluated by Fisher's exact test.…”

Section: Discussionmentioning

confidence: 99%

“…3,5,6,8,9,[18][19][20] Some authors advocate the use of mitomycin C (MMC) intraoperatively to reduce fibrosis formation, [21][22][23][24][25][26] although granulation tissue has been reported to form around the ostia following MMC application during EES-DCR. 27,28 Hyaluronan is a ubiquitous polysaccharide component of the extracellular matrix. Both hyaluronan and its derivatives have been reported to reduce scarring and to promote wound healing in naso-sinal surgery.…”

Section: Introductionmentioning

confidence: 99%

Effects of Merogel coverage on wound healing and ostial patency in endonasal endoscopic dacryocystorhinostomy for primary chronic dacryocystitis

Cannon

Yan

et al. 2011

Eye

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Purpose To investigate the effects of Merogel coverage on ostial patency in endonasal endoscopic dacryocystorhinostomy (EES-DCR) for primary chronic dacryocystitis (PCD). Methods In all, 260 patients with unilateral PCD were randomized into two groups: the Merogel group and the control group. All patients underwent EES-DCR. The Merogel group received Merogel covering the wound 1-2 mm around the ostium and the control group received no treatment. Patients were followed up for 9 months. The mucosal epithelialization of the wound, the proliferation of fibrosis tissue, and the success rate of ostial patency were compared. Results Our study included 112 patients in the Merogel group and 115 patients in the control group. At the 2-week review, intact mucosal epithelium lined the ostia in 96 Merogel patients compared with 80 control patients (ITT analysis: v 2 ¼ 4.502, P ¼ 0.034). At the 9-month review, scars were present in 18 patients in the Merogel group compared with 39 patients in the control group (ITT analysis: v 2 ¼ 9.909, P ¼ 0.002, ITT analysis). No differences were observed in the granulation formation between the two groups. The success rate of ostial patency reached 94.6% (106/112) in the Merogel group compared with 80% (92/115) in the control group (ITT analysis: v 2 ¼ 4.151, P ¼ 0.042). Conclusion Merogel coverage may enhance the success rate of EES-DCR for PCD by promoting mucosal epithelial healing and preventing excessive scarring.

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“…5 Roozitalab et al (2004) said that use of intraoperative MMC in DCR does not change success rate of this procedure. 6 Farahani et al (2008) conducted prospective doubleblind randomized clinical trial and showed that patients with nasolacrimal duct obstruction who underwent endoscopic DCR did not benefit from adjunctive topical application of MMC. 7 Although, clinically there were lesser complications in MMC group as compared to the control group but statistically they were not significant but the results were comparable to the above studies.…”

Section: Discussionmentioning

confidence: 98%

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

Jain¹,

Vashistha²,

Kaushik³

2013

An International Journal Clinical Rhinology

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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.

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Results of the Application of Intraoperative Mitomycin C in Dacryocystorhinostomy

Abstract: The authors conclude that the use of intraoperative MMC in DCR surgery does not change the success rate of this procedure.

Cited by 53 publications

References 7 publications

Bicanalicular double silicone stenting in endoscopic dacryocystorhinostomy with lacrimal trephination in distal or common canalicular obstruction

Bicanalicular double silicone stenting in endoscopic dacryocystorhinostomy with lacrimal trephination in distal or common canalicular obstruction

Effects of Merogel coverage on wound healing and ostial patency in endonasal endoscopic dacryocystorhinostomy for primary chronic dacryocystitis

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

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