DOI: http://dx.doi.org/10.18203/issn.2454-5929.ijohns20184355

Efficacy of mitomycin c in endoscopic dacryocystorhinostomy

Vinod Shinde, Anju Unnikrishnan, Shad Fatma, James Thomas

Abstract


Background: Endoscopic dacryocystorhinostomy is a procedure done to drain the lacrimal sac due to post saccular lacrimal obstruction. The most common cause of failure of dacryocystorhinostomy is blockage of ostium created in lacrimal sac. Various methods are employed to prevent the blockage such as stenting, mitomycin C and steroidal nasal sprays. In this study we evaluated the efficacy of mitomycin C in reducing the stomal closure following dacryocystorhinostomy.

Methods: Fifty patients who were diagnosed with chronic dacryocystitis due to nasolacrimal duct obstruction were chosen for the study. They were randomly divided in to two groups. In group I 25 patients under went endoscopic dacryocystorhinostomy with intraoperative mitomycin C application and in group II 25 patients underwent endoscopic dacryocystorhinostomy without application of mitomycin C. Patients were followed up at the end of one week, three weeks, three months and six months. Surgical success was evaluated objectively at the end of six months.  

Results: The success rate of endoscopic dacryocystorhinostomy with use of mitomycin c was 86% in group where mitomycin c was used and 62% in group where mitomycin c was not used.

Conclusions: Mitomycin C is a safe drug which can keep the stoma created patent and reduces the chance of recurrence following endoscopic dacryocystorhinostomy.


Keywords


Chronic dacryocystitis, Nasolacrimal duct obstruction, Dacryocystorhinostomy, Endoscopic endonasal dacryocystorhinostomy, Mitomycin C

Full Text:

PDF

References


Yung MN, Hardman Lea S. Analysis of the results of surgical endoscopic dacryocystorhinostomy: Effect of the level of obstruction. Br J Ophthalmol. 2002;86(7):792–4.

Mangal S, Vimal J, Gupta SC. Intranasal Endoscopic DCR (END-DCR) in cases of dacryocystitis. Indian J Otolaryngol Head Neck Surg. 2004;56(3):177–83.

Mortimre S, Banhegy GY, Lancaster JL. Endoscopic DCR without silicon stenting. J R Coll Syrg Edinb. 1999;44:371–3.

Wormald PJ. Powered endoscopic dacryocystorhinostomy. 2002;112(1):69–72.

Apuhan T, Eroglu F, Sipahier A, Yildirim YS. Effect of mitomycin C on endoscopic dacryocystorhinostomy. J Craniofac Surg, 2011;22(6):2057-9.

Selig YK, Biesman BS, Rebeiz EE. Topical application of mitomycin-C in endoscopic dacryocystorhinostomy. Am J Rhinol. 2000;14:205-7.

Ressionitis T, Voros GM, Vasilios TK. Clinical outcome of endonasal KTP laser assisted dacryocystorhinostomy. BMC Ophthalmol. 2005;5.

Kao SC, Liao CL, Tseng JH, Chen MS, Hou PK. Dacryocystorhinostomy with intraoperative mitomycin C. Ophthalmology. 1997;104:86-91.

You YA, Fang CT. Intraoperative mitomycin C in dacryocystorhinostomy. Ophthal Plast Reconstr Surg. 2001;17(2):115-9.

Cheng SM, Feng YF, Xu L, Li Y, Huang JH. Efficacy of mitomycin C in endoscopic dacryocystorhinostomy: A systematic review and meta-analysis. PLoS One. 2013;8:e62737.

Gonzalvo Ibáñez FJ, Fuertes Fernández I, Fernández Tirado FJ, Hernández Delgado G, Rabinal Arbués F, Honrubia López FM. External dacryocystor-hinostomy with mitomycin C. Clinical and anatomical evaluation with helical computed tomography. Arch Soc Esp Oftalmol. 2000;75:611-7.

Rathore PK, Kumari Sodhi P, Pandey RM. Topical mitomycin C as a postoperative adjunct to endonasal dacryocystorhinostomy in patients with anatomical endonasal variants. Orbit. 2009;28:297-302.

Deka A, Bhattacharee K, Bhuyan SK, Barua CK, Bhattacharjee H, Khaund G. Effect of mitomycin C on ostium in dacryocystorhinostomy. Clin Experiment Ophthalmol. 2006;34:557-61.