Effect of mitomycin C on ostium in dacryocystorhinostomy.
BACKGROUND
To observe the effect of intraoperative mitomycin C of varying concentration on postoperative ostium size after external dacryocystorhinostomy (DCR).


METHODS
In this prospective controlled study, 60 cases of DCR were taken up irrespective of age and sex. Cases were divided into three groups. Group 1 was taken as a control group and operated without mitomycin C; in experimental group 2 and group 3, mitomycin C at a concentration of 0.05 mg/mL and 0.4 mg/mL was applied, respectively, for 2 min. Each group consisted of 20 cases. Half of the cases in each group underwent single-flap DCR (SFDCR) and half underwent double-flap DCR (DFDCR) surgery. Nasal endoscopic evaluation was performed on the first postoperative day, at 2 weeks and at 6 months after surgery. A Student's t-test was used to compare the osteotomy size of each group.


RESULTS
At the end of the final follow up, average size of the ostium in group 1 was 3.6+/-2.36 mm2 in SFDCR and 4.5+/-3.59 mm2 in DFDCR, in group 2 was 4.8+/-4.82 mm2 in SFDCR and 4.9+/-4.12 mm2 in DFDCR, and in group 3 was 16.6+/-6.80 mm2 in SFDCR and 17.5+/-9.07 mm2 in DFDCR. The ostium size in group 3 was found to be significantly bigger in comparison with group 1 (P=0.0001 in SFDCR, P=0.001 in DFDCR) and with group 2 (P=0.0009 in SFDCR, P=0.001 in DFDCR). No statistically significant difference of ostium size was found in SFDCR and DFDCR.


CONCLUSIONS
Mitomycin C in appropriate dose minimizes postoperative fibrosis and granulations, thereby maintaining a bigger postoperative ostium throughout the postoperative observation period.
Deka
Amarendra
A
Oculoplasty Service, Regional Institute of Ophthalmology, Gauhati Medical College and Hospital, Sri Sankaradeva Nethralaya, Guwahati, India. mintu_deka@yahoo.co.in
Bhattacharjee
Kasturi
K
Bhuyan
Saurabh Kr
SK
Barua
Chiranjib Kumar
CK
Bhattacharjee
Harsha
H
Khaund
Gautom
G
D000293:Adolescent; D000328:Adult; D000477:Alkylating Agents / Q000008:administration & dosage*; D049109:Cell Proliferation / Q000187:drug effects; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D003608:Dacryocystorhinostomy / Q000379:methods*; D005260:Female; D005355:Fibrosis / Q000517:prevention & control; D006801:Humans; D007223:Infant; D007430:Intraoperative Care; D007767:Lacrimal Duct Obstruction / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage*; D009301:Nasolacrimal Duct / Q000473:pathology; D010030:Ostomy; D011183:Postoperative Complications / Q000517:prevention & control; D011446:Prospective Studies
D000477:Alkylating Agents; D016685:Mitomycin