[External dacryocystorhinostomy with mitomycin C. Clinical and anatomical evaluation with helical computed tomography].
OBJECTIVE
To study the effect of intraoperative mitomycin C (MMC) in external dacryocystorhinostomy (DCR), on the clinical evolution and osteotomy size with helical computed tomography (HCT).


METHODS
A total of 17 patients who had undergone DCR were randomly assigned to either a control group (8 patients) or an MMC group (9 patients). Intraoperative MMC (0.2 mg/ml/2 minutes) was applied to the osteotomy site. HCT scans were performed within 24 hours after surgery and then at 1, 3 and 6 months. The epiphora grade and lacrimal drainage system irrigation were evaluated after surgery. A computer-aided three-dimensional and multiplanar reconstruction was used to calculate the surface area of the osteotomy site.


RESULTS
The mean follow-up was 10.47+/-4.1 months (range= 6-18 months). All patients (100%) remain asymptomatic in the MMC group and 5 patients (75%) in the control group. In the MMC group the percentage of the remaining osteotomy size in comparision with the osteotomy size immediately after surgery at the end of the sixth postoperative month was 93.82+/-4.55%, whereas that of the control group was only 64.81+/-9.68% (p<0,001). Statistically significant differences were noted at 1, 3 and 6 months.


CONCLUSIONS
Intraoperative MMC may increase the success rates over the traditional DCR procedure and is effective in reducing the closure rate of the osteotomy after DCR.
Gonzalvo Ibáñez FJ
Hospital Universitario Miguel Servet, Zaragoza, España.
Fuertes Fernández I
Fernández Tirado FJ
Hernández Delgado G
Rabinal Arbués F
Honrubia López FM
D000293:Adolescent; D000328:Adult; D003608:Dacryocystorhinostomy / Q000379:methods*; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000627:therapeutic use*; D014057:Tomography, X-Ray Computed / Q000379:methods
D016685:Mitomycin