title: Endoscopic dacryocystorhinostomy not using canalicular silicone intubation tube with and without mitomycin C: a comparative study.
abstract: OBJECTIVE
  To determine the outcome and safety of endoscopic dacryocystorhinostomy (EN-DCR) with the use of adjunctive mitomycin C (MMC) in nasolacrimal duct obstruction in adults.
  
  
  METHODS
  In this retrospective, comparative case series, 54 consecutive adult patients underwent EN-DCR. We performed endonasal dacryocystorhinostomy with adjunctive MMC in 28 patients and endonasal dacryocystorhinostomy without MMC in 26 patients. All patients underwent a standardized procedure, with an endonasal approach to the lacrimal sac, surgical removal of nasal mucosa, lacrimal bone, and a fragment of the frontal process of the maxilla. The medial wall of the lacrimal sac was removed completely. In the study group (28 patients), a neurosurgical cottonoid soaked in MMC at 0.5 mg/mL was placed at the osteotomy site for 5 minutes (not using canalicular silicone intubation tube). In the other group (26 patients), standard endonasal dacryocystorhinostomy technique was used without MMC (not using canalicular silicone intubation tube). Main outcome measures were resolution of epiphora, absence of discharge, and patency of the ostium confirmed by irrigation at 6 months.
  
  
  RESULTS
  The EN-DCR procedure with adjunctive MMC was successful in 24 (85.71%) cases. The mean follow-up was 14.3 months (8-24 months). No significant complications were encountered. In the control group, the EN-DCR was successful in 19 patients (73.07%). The mean follow-up was 13.2 months (6-24 months).
  
  
  CONCLUSIONS
  Endoscopic dacryocystorhinostomy with MMC is a safe and successful procedure for the treatment of nasolacrimal duct obstruction in adults.
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Tekden Medical Center, Kayseri, Turkey. dramahmut@yahoo.com
authors.forename: Mahmut
authors.initials: M
authors.lastname: Özkiris
authors.forename: Abdullah
authors.initials: A
authors.lastname: Özkiris
mesh_terms: D000328:Adult; D000368:Aged; D000477:Alkylating Agents / Q000008:administration & dosage*; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D003608:Dacryocystorhinostomy / Q000379:methods*; D004724:Endoscopy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007440:Intubation; D007767:Lacrimal Duct Obstruction / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage*; D009301:Nasolacrimal Duct / Q000187:drug effects / Q000601:surgery; D012189:Retrospective Studies; D012826:Silicone Elastomers; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000477:Alkylating Agents; D012826:Silicone Elastomers; D016685:Mitomycin