Authors: Vaidyanathan Venkatraman Deepak Balasubramanian Suria Gopalakrishnan Sunil Kumar Saxena Nirmal Shanmugasundaram
Publish Date: 2011/12/13
Volume: 269, Issue: 7, Pages: 1791-1794
Abstract
In recent literature there has been an interest in the use of Mitomycin C to reduce postoperative complications following endoscopic sinus surgery We report our results on a prospective randomized controlled trial involving 50 patients with chronic bilateral rhino sinusitis We eliminated various confounding factors by studying a single group of patients with symmetrical disease without preexisting gross anatomical abnormalities Patients requiring revision sinus surgery were excluded On completion of the surgery a cotton pledget soaked in Mitomycin C was placed in one nostril test and salinesoaked pledget control was placed in the other side of the nose both in the middle meatus The side of the nasal cavity receiving the topical Mitomycin C was randomized The patients were assessed periodically first week first month third month and sixth month for synechiae formation and presence or absence of their symptoms At the first week follow up there was a statistically significant difference in the incidence of synechiae between the saline and Mitomycin C side Furthermore there was a statistically significant improvement with regards to patient symptoms nasal block and discharge in the Mitomycin C side when compared to the saline side At the third and sixth month there was no difference between the two groups The incidence of adverse tissue reaction granulation discharge polypoidal mucosa and crusting was less in the Mitomycin C side when compared to the saline side at the first month follow up Topically applied Mitomycin C reduces the incidence of synechiae in the immediate postoperative period in patients undergoing endoscopic sinus surgery There is also an improvement in nasal obstruction and discharge with a reduction in the incidence of adverse tissue reaction in the early postoperative period
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