Mitomycin C for the prevention of adhesion formation after endoscopic sinus surgery: A randomized, controlled study

被引:97
作者
Chung, JH
Cosenza, MJ
Rahbar, R
Metson, RB
机构
[1] Harvard Univ, Sch Med, Dept Otol & Laryngol, Boston, MA 02115 USA
[2] Massachusetts Eye & Ear Infirm, Dept Otolaryngol, Boston, MA 02114 USA
[3] Childrens Hosp, Dept Otolaryngol & Commun Disorders, Boston, MA 02115 USA
关键词
D O I
10.1067/mhn.2002.124705
中图分类号
R76 [耳鼻咽喉科学];
学科分类号
100213 ;
摘要
OBJECTIVE. Mitomycin C (MMC) is an antineoplastic agent that has been shown to decrease scar tissue after ophthalmologic surgery. Our goal was to determine whether the application of MMC at the conclusion of sinus surgery decreases the incidence of postoperative adhesion formation. METHODS: At the completion of endoscopic sinus surgery in 55 patients, a cotton pledget saturated with 1 mL of 0.4 mg/mL MMC was placed for 4 minutes in the right or left middle meatus and a similar saline-soaked pledget was placed on the opposite side. Patients were examined postoperatively by a masked observer for the presence of synechiae and mucosal changes. RESULTS: Postoperative adhesions were observed in 16 patients (29%) with a mean follow-up of 4.1 months. These adhesions were bilateral in 6 patients (10.9%) and unilateral in 10 patients (18%). Unilateral adhesions were observed on only 2 sides (3.6%) treated with MMC and 8 controls (14.5%) (P = 0.058). No adverse effects were observed. CONCLUSIONS. MMC was found to be safe to use during sinus surgery; and it may reduce the incidence of postoperative adhesions at the dosage used in this study. SIGNIFICANCE: Because of the observed trend toward decreased synechiae formation with MMC application, further trials using higher concentrations and application times are warranted.
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页码:468 / 474
页数:7
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