Role of mitomycin C in reducing adhesion formation following endoscopic sinus surgery

Abstract

Objective: To study the role of mitomycin C in reducing adhesion formation following endoscopic sinus surgery.

Study design: Prospective, randomized, controlled trial.

Setting: Tertiary care referral centre.

Patients: Thirty patients were selected suffering long-term problems with bilateral chronic rhinosinusitis, with no relief obtained from medical therapy. Patients requiring revision sinus surgery or having acute upper respiratory tract infection were excluded.

Interventions: Diagnostic nasal endoscopies and non-contrast computerized tomography of nose and paranasal sinuses were undertaken and, following confirmation of the diagnosis, functional endoscopic sinus surgery (FESS) was carried out bilaterally using the Messerklinger technique. On completion of the surgery, a cotton wick soaked in mitomycin C was placed in one or other side of the nose in the middle meatus. Follow up was for three months and patients were assessed for subjective and objective improvement in their symptoms.

Results: Post-operatively, of the 11 (36.6 per cent) patients complaining of persistent nasal obstruction, nine had complaints limited to the control side only (p=0.005). Out of the nine (30 per cent) patients complaining of recurrent nasal discharge, eight had complaints on the control side and only one reported discharge from both sides (p=0.006).

Conclusion: Mitomycin C may be topically applied in post-operative FESS cases to reduce adhesion formation and hence the need for revision surgery.