Mitomycin C for the prevention of adhesion formation after endoscopic sinus surgery: a randomized, controlled study.
OBJECTIVE
Mitomycin C (MMC) is an antineoplastic agent that has been shown to decrease scar tissue after ophthalmologic surgery. Our goal was to determine whether the application of MMC at the conclusion of sinus surgery decreases the incidence of postoperative adhesion formation.


METHODS
At the completion of endoscopic sinus surgery in 55 patients, a cotton pledget saturated with 1 mL of 0.4 mg/mL MMC was placed for 4 minutes in the right or left middle meatus and a similar saline-soaked pledget was placed on the opposite side. Patients were examined postoperatively by a masked observer for the presence of synechiae and mucosal changes.


RESULTS
Postoperative adhesions were observed in 16 patients (29%) with a mean follow-up of 4.1 months. These adhesions were bilateral in 6 patients (10.9%) and unilateral in 10 patients (18%). Unilateral adhesions were observed on only 2 sides (3.6%) treated with MMC and 8 controls (14.5%) (P = 0.058). No adverse effects were observed.


CONCLUSIONS
MMC was found to be safe to use during sinus surgery, and it may reduce the incidence of postoperative adhesions at the dosage used in this study.


CONCLUSIONS
Because of the observed trend toward decreased synechiae formation with MMC application, further trials using higher concentrations and application times are warranted.
Chung
Jeannie H
JH
Department of Otology and Laryngology, Harvard Medical School, Boston, MA, USA.
Cosenza
Mathew J
MJ
Rahbar
Reza
R
Metson
Ralph B
RB
D000328:Adult; D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use*; D004724:Endoscopy / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000627:therapeutic use*; D009297:Nasal Mucosa / Q000187:drug effects / Q000473:pathology; D010256:Paranasal Sinuses / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications; D012852:Sinusitis / Q000473:pathology / Q000601:surgery*; D013997:Time Factors; D000267:Tissue Adhesions / Q000209:etiology* / Q000473:pathology / Q000517:prevention & control*; D016896:Treatment Outcome
D000903:Antibiotics, Antineoplastic; D016685:Mitomycin