title: Quantifying the Ototoxicity of Mitomycin: Before versus after Myringotomy.
abstract: OBJECTIVE
  Recent research has focused on mitomycin C (MMC) application as a means to circumvent complications that arise when using ventilation tubes during myringotomy. This study has two aims: (1) to synergize the current literature to create a standardized clinical approach for using MMC, and (2) to determine at which point during the myringotomy the application of MMC proves the safest (i.e., before or after incision).
  
  
  METHODS
  We measured the auditory brainstem response (ABR) and distortion product otoacoustic emissions (DPOAE) in 9 female chinchillas to determine whether applying MMC before or after incision was also the safest. The tests were then repeated on days 3, 10 and 17.
  
  
  RESULTS
  The change in the ABR thresholds from baseline was greater in the experimental than in the control group; however, after stratification, the 'after' group experienced a statistically significant change (19.38 ± 8.26) on day 17, whereas the 'before' group did not (2.00 ± 3.26; p = 0.003). No such changes were seen with DPOAE testing.
  
  
  CONCLUSIONS
  Mitomycin is less ototoxic to the middle ear when applied before myringotomy is done. We recommend future studies to apply the clinical approach we have designed to standardize its use in selected cases.
authors.affiliation: McGill University, Montreal, Que., Canada.
authors.forename: Michael
authors.initials: M
authors.lastname: Roskies
authors.forename: Dan
authors.initials: D
authors.lastname: Citra
authors.forename: Sam J
authors.initials: SJ
authors.lastname: Daniel
mesh_terms: D000287:Administration, Topical; D000818:Animals; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage / Q000633:toxicity; D002682:Chinchilla; D004195:Disease Models, Animal; D004305:Dose-Response Relationship, Drug; D016057:Evoked Potentials, Auditory, Brain Stem / Q000187:drug effects*; D005260:Female; D008876:Middle Ear Ventilation; D016685:Mitomycin / Q000008:administration & dosage / Q000633:toxicity*; D010035:Otitis Media, Suppurative / Q000188:drug therapy* / Q000601:surgery; D017084:Otoacoustic Emissions, Spontaneous / Q000187:drug effects*; D011182:Postoperative Care; D011300:Preoperative Care
chemical_list: D000903:Antibiotics, Antineoplastic; D016685:Mitomycin