Mitomycin C and endoscopic sinus surgery: where are we?
OBJECTIVE
Mitomycin C has been used successfully in various ophthalmologic and, more recently, otolaryngologic procedures. Its modulation of fibroblast activity allows for decreased scarring and fibrosis. Several recent trials have examined the efficacy of mitomycin C in reducing synechia and stenosis following endoscopic sinus surgery.


RESULTS
Basic science studies using fibroblast cell lines have demonstrated a dose-dependent suppression of activity with the use of mitomycin C. This is further supported by animal studies that have shown lower rates of maxillary ostial restenosis following application of mitomycin C. No human trial, however, has demonstrated a statistically significant impact of mitomycin C on the incidence of postoperative synechia or stenosis following sinus surgery. The limitations of the literature are discussed.


CONCLUSIONS
The antiproliferative properties of mitomycin C may theoretically decrease the incidence of synechia and stenosis following endoscopic sinus surgery. Although this is supported by basic science studies and its successful use in other fields, the clinical evidence to date has not shown the application of mitomycin C to be effective in preventing stenosis after endoscopic sinus surgery. Future prospective studies are required before definitive conclusions can be made.
Tabaee
Abtin
A
Department of Otorhinolaryngology, Weill Medical College of Cornell University, New York, NY 10021, USA.
Brown
Seth M
SM
Anand
Vijay K
VK
D000818:Animals; D000903:Antibiotics, Antineoplastic / Q000494:pharmacology / Q000627:therapeutic use*; D002921:Cicatrix / Q000209:etiology / Q000517:prevention & control*; D004724:Endoscopy / Q000009:adverse effects; D006801:Humans; D016685:Mitomycin / Q000494:pharmacology / Q000627:therapeutic use*; D009297:Nasal Mucosa / Q000187:drug effects; D010256:Paranasal Sinuses / Q000601:surgery*; D000267:Tissue Adhesions / Q000209:etiology / Q000517:prevention & control
D000903:Antibiotics, Antineoplastic; D016685:Mitomycin