title: Effect of mitomycin C on revision endoscopic dacryocystorhinostomy.
abstract: OBJECTIVE
  The objectives of the study were to compare the outcome and success rate of revision endoscopic dacryocystorhinostomy (EN-DCR) with or without use of adjunctive mitomycin C (MMC) in cases with dacryocystorhinostomy (DCR) failure.
  
  
  METHODS
  Thirty-six consecutive adult patients underwent revision EN-DCR. The patients were divided into 2 groups. In group 1 (18 patients), a neurosurgical cottonoid soaked in MMC at 0.5 mg/mL was placed at the osteotomy site for 5 minutes (using canalicular silicone intubation tube). In the other group (18 patients), standard endoscopic dacryocystorhinostomy technique was used without MMC (using canalicular silicone intubation tube). Successful DCR was defined as relief of symptoms (resolution of epiphora and absence of discharge) as demonstrated by saline irrigation at the last postoperative visit.
  
  
  RESULTS
  The EN-DCR procedure with adjunctive MMC was successful in 16 (88.88%) cases. The mean follow-up was 11.5 months (7-19 months). No significant complications were encountered. In the control group, the EN-DCR was successful in 10 patients (55.55%). The mean follow-up was 12.7 months (6-22 months). The difference between the 2 groups was statistically significant (P < 0.05).
  
  
  CONCLUSIONS
  Recurrent nasolacrimal duct obstruction after primary DCR is mainly due to reclosure of the nasolacrimal stoma and osteotomy site with granulation tissue. Adjunctive use of intraoperative MMC seems to be a safe adjuvant that could help in increasing the success rates of revision EN-DCR surgery.
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Bozok University Medical Faculty, Yozgat, Turkey. mozkiris@yahoo.com
authors.forename: Mahmut
authors.initials: M
authors.lastname: Ozkiriş
authors.forename: Abdullah
authors.initials: A
authors.lastname: Ozkiriş
authors.forename: Sertan
authors.initials: S
authors.lastname: Göktaş
mesh_terms: D000328:Adult; D000368:Aged; D000477:Alkylating Agents / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003608:Dacryocystorhinostomy / Q000379:methods*; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000627:therapeutic use*; D012008:Recurrence; D012086:Reoperation; D016896:Treatment Outcome
chemical_list: D000477:Alkylating Agents; D016685:Mitomycin