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Article Published In Vol.4 (Sept-Oct-2016)

The Efficacy of Application of Mitomycin-C in Endoscopic Endonasal Dacryocystorhinostomy

Author : Dr.Sajad Al-Helo and Dr.Hyder Sarhan

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Design: Prospective study.
Aim of the study: Aim of this study is to evaluate the efficacy of application of Mitomycin-C intraoperatively to the created stoma in endoscopic endonasal dacryocystorhinostomy(DCR)&compared the results with results of endoscopic endonasal DCR procedure without Mitomycin-C.
Time and place: Study was performed in Al-Sadder medical city in AL-Najaf Governorate during the period from March 2012 to April 2014.
Patients and methods: Sixty seven eyes of 64 patients , there were 46 females and 18 males ranging in age from 5 to 56 years. Patients were randomly divided into 2 groups: group1 an endonasal endoscopic DCR surgery done without Mitomycin-C application and group2 in which 0.2 mg/ml Mitomycin-C was applied to created stoma for 5 min.
Results: Mean age for male is 21.7 years and for female 35.29 years. Nasal synecchia was identified in the ipsilateral site of surgery in 5(15.625%) patients in group1 and 3(9.375%)patients in group2. Two patient (6.25%) in group1, and one patient (3.125%) in group2 developed granulation tissue around the stoma and represent as failure operation.
Conclusion: The endoscopic DCR is a relatively safe and effective procedure for treatment of distal lacrimal apparatus obstruction. Endoscopic DCR should be considered in all age group patients and in patients who wish to avoid a facial scar . It is difficult to make a definite evidence-based determination about the relative efficacy of Mitomycin-C application in endonasal endoscopic DCR because there was many studies that show highly successful rate of use of Mitomycin-C and other studies denied this possibility.Antimitotic agents is a new treatment modality in endoscopic lacrimal surgery , its intraoperative use seems to be easy and safe, but in our study and others limited series showed no benefit in the use of the drug.
Keywords: Endoscopic Endonasal Dacryocystorhinostomy (DCR) , Mitomycin -C, Nasolacrimal duct obstruction, Epiphora etc.

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