Role of Mitomycin C in Endoscopic Management of Nasolacrimal Duct Obstruction

Authors

  • Muhammad Umar Farooq Department of ENT-Head & Neck Surery, Dow University of Health Sciences and Civil Hospital, Karachi, Pakistan.
  • Murtaza Ahsan Department of ENT-Head & Neck Surery, Dow University of Health Sciences and Civil Hospital, Karachi, Pakistan.
  • Iqbal A. Muhammad Khyani Department of ENT-Head & Neck Surery, Dow University of Health Sciences and Civil Hospital, Karachi, Pakistan.

Abstract

Objective: To study the effects of mitomycin C in prevention of recurrent stenosis adhesion formation in endoscopic management of obstructed nasolacrimal duct.
Study Design: Quasi experimental design.
Place & Duration: The study was conducted at the department of ENT-Head & Neck Surgery, Dow University of Health Sciences, Karachi from September 2002 to September 2012. Patients were selected from different hospitals including Faiz-e-Aam Hospital, Mid City Hospital, National Medical Centre and Civil Hospital, Karachi.
Subject & Methods: Clinical records of 82 patients, who were diagnosed to have nasolacrimal duct obstruction and managed by transnasal endoscopic approach, were reviewed. Participants were randomly divided in two groups depending upon application of mitomycin C intra-operatively. Demographic data was collected including age, gender, associated nasal pathologies, or concomitant nasal surgery performed, post operative relief of epiphora and complications if any, were recorded on institutional approved performa. Patients were followed up for 3 to 6 months. Surgical success was defined by complete relief from epiphora and free drainage of nasolacrimal duct, after 3 and 6 months of follow up.

Results: Mitomycin C was applied in more than half of our patients 54.9 % (n=45/82). Out of which 93.3% (n=42/45) were completely relieved from epiphora within six months, and only 6.6% (n=3/45) patients had developed synechiae. In contrast, 45.1 % (n=37) patient in whom mitomycin C was not applied, complete recovery from symptoms was observed in 78.3% (n=29/37), and 21.6% (n=8/37) patient had developed nasal synechiae. The results were statistically analysed using Chi-Square test.

 

Downloads

Download data is not yet available.

References

Karkos PD, Leong SC, Sastry A, Assimakopoulos AD, Swift AC. Evidence-based applications of mitomycin C in the nose. Am J Otolaryngol 2011;32:422-5.

Leong SC, Macewen CJ, White PS. A systematic review of outcomes after dacryocystorhinostomy in adults. Am J Rhinol Allergy 2010; 24:81-90.

Sharma BR. Non endoscopic endonasal dacryocystorhinostomy versus external dacryocystorhinostomy. Kathmandu Univ Med J 2008; 6:437-42.

Agarwal S. Endoscopic dacryocystorhinostomy for acquired nasolacrimal duct obstruction. J Laryngol Otol 2009; 123:1226-8.

Onerci M. Dacryocystorhinostomy. Diagnosis and treatment of nasolacrimal canal obstructions. Rhinology 2002; 40:49-65.

Jones LT. The cure of epiphora due to canalicular disorders, trauma and surgical failures on the lacrimal passages. Trans Am Acad Ophthalmol Otolaryngol 1962;66:506.

McDonough M, Meiring JH. Endoscopic transnasal dacryocystorhinostomy. J Laryngol Otol 1989; 103: 585-7.

Ishio K, Sugasawa M, Tayama N, Kaga K. Clinical usefulness of endoscopic intranasal dacryocystorhinostomy. Acta Otolaryngol Suppl 2007; 559:95-102.

Zaidi FH, Symanski S, Olver JM. A clinical trial of endoscopic vs external dacryocystorhinostomy for partial nasolacrimal duct obstruction 2011; 25:1219-24.

Rahman A, Channa S, Niazi JH, Memon MS. Dacryocystorhinostomy without intubation with intraoperative mitomycin-C 2006; 16:476-8.

Rathore PK, Kumari Sodhi P, Pandey RM.Topical mitomycin C as a postoperative adjunct to endonasal dacryocystorhinostomy in patients with anatomical endonasal variants 2009; 28:297-302.

Penttilä E, Smirnov G, Seppä J, Kaarniranta K, Tuomilehto H. Mitomycin C in revision endoscopic dacryocystorhinostomy: a prospective randomized study. Am J Rhinol Allergy 2011; 25:425-8.

Prasannaraj T, Kumar BY, Narasimhan I, Shivaprakash KV. Significance of adjunctive mitomycin C in endoscopic dacryocystorhinostomy. Am J Otolaryngol 2012; 33:47-50.

Farooq MU, Ansari MA. Cerebrspinal fluid rhinorrhea: etiology, site of leakage and endoscopic management. J Coll Physicians Surg Pak 2011; 21:460-3.

Korkut AY, Teker AM, Ozsutcu M, Askiner O, Gedikli O. A comparison of endonasal with external dacryocystorhinostomy in revision cases. Eur Arch Otorhinolaryngol 2011; 268:377-81.

Araujo Filho BC, Voegels RL, Butugan O, Pinheiro Neto CD, Endoscopic dacryocystrhinostomy. Braz J Otorhinolaryngol 2005; 71:721-5.

Apuhan T, Yýldýrým YS, Eroglu F, Sipahier A. Effect of mitomycin C on endoscopic dacryocystorhinostomy. J Craniofac Surg 2011; 22:2057-9.

Jin HR, Yeon JY, Choi MY. Endoscopic dacryocystorhinostomy: creation of a large marsupialized lacrimal sac. J Korean

Med Sci 2006; 21:719-23.

Ozkiris M, Ozkiris A. Endoscopic dacryocystorhinostomy not using canalicular silicone intubation tube with and without mitomycin C: a comparative study. Eur J Ophthalmol 2012; 22:320-5.

Smirnov G, Tuomilehto H, Teräsvirta M, Nuutinen J, Seppä J. Silicone tubing is not necessary after primary endoscopic dacryocystorhinostomy: a prospective randomized study. Am J Rhinol 2008; 22:214-7.

Yigit O, Samancioglu M, Taskin U, Ceylan S, Eltutar K, Yener M. External and endoscopic dacryocystorhinostomy in chronic dacryocystitis: comparison of results. Eur Arch Otorhinolaryngol 2007; 264:879-85.

Korkut AY, Teker AM, Yazici MZ, Kahya V, Gedikli O, Kayhan FT Surgical outcomes of primary and revision endoscopic dacryocystorhinostomy. J Craniofac Surg 2010; 21:1706-8.

Codere F, Denton P, Corona J. Endonasal dacryocystorhinostomy: a modified technique with preservation of the nasal and lacrimal mucosa. Ophthal Plast Reconstr Surg 2010; 26:161-4.

Henson RD, Cruz HL, Henson RG Jr, Ali MJ, Kakizaki H. Postoperative application of mitomycin-C in endocanalicular laser dacryocystorhinostomy. Ophthal Plast Reconstr Surg 2012; 28:192-5.

Henson RD, Henson RG Jr, Cruz HL Jr, Camara JG. Use of the diode laser with intraoperative mitomycin C in endocanalicular laser dacryocystorhinostomy. Ophthal Plast Reconstr Surg 2007; 23:134-7.

Dolmetsch AM. Nonlaser endoscopic endonasal dacryocystorhinostomy with adjunctive mitomycin C in nasolacrimal duct obstruction in adults. Ophthalmology 2010; 117:1037-40.

Dolmetsch AM, Gallon MA, Holds JB. Nonlaser endoscopic endonasal dacryocystorhinostomy with adjunctive mitomycin C in children. Ophthal Plast Reconstr Surg 2008; 24:390-3.

Downloads

Published

2013-08-04

How to Cite

Farooq, M. U. ., Ahsan, M., & Khyani, I. A. M. . (2013). Role of Mitomycin C in Endoscopic Management of Nasolacrimal Duct Obstruction. Journal of the Dow University of Health Sciences (JDUHS), 7(2), 63–67. Retrieved from https://jduhs.jduhs.duhs.edu.pk/index.php/jduhs/article/view/1549

Issue

Section

Original Articles

Most read articles by the same author(s)