Study of Endonasal Endoscopic Dacryo-cystorhinostomy with special reference to Mitomycin-C

Madhu Priya; Manish P Puttewar; Shraddha Jain Kumar; Satvinder Singh Bakshi

Volume : VII, Issue : XI, November - 2017

Study of Endonasal Endoscopic Dacryo-cystorhinostomy with special reference to Mitomycin-C

Madhu Priya, Manish P Puttewar, Shraddha Jain Kumar, Satvinder Singh Bakshi

Abstract :

Objective: The aim of this study was to evaluate long–term results in patients with nasolacrimal duct obstruction treated with intranasal endoscopic dacryo–cystorhinostomy with intraoperative topical application of mitomycin–C.

Methods: The procedure was carried out in 34subjects (41eyes). Patients with post–saccal stenosis were divided into two groups, 21patients were treated with intranasal endoscopic dacryo–cystorhinostomy with intraoperative application of Mitomycin–C and the other 20cases underwent procedure only without Mitomycin–C. Effectiveness of drug at rhinostomy site was assessed in relation to granulation formation, adhesions and ostium size. Outcome measures were assessed on the basis of relief of subjective symptoms, patency of rhinostomy site confirmed via syringing and final ostium size at end of 6months, 1year and 2years.

Results: The success rate was 100% at 3 and 6 months follow–up in both the groups. At the end of one year, one failure was noted in control group which had to undergo revision endoscopic DCR with overall success rate decreasing to 97%. This was maintained at the end of second year. Results revealed that adjunctive use of Mitomycin–C was effective at 3months when granulation tissue formation was significantly lesser in MMC group compared to no MMC group. Topical application of Mitomycin–C has been found to be beneficial in preventing adhesions and also resulted in larger neo–ostium.

Conclusion: We concluded that results with intraoperative topical application of Mitomycin–C in endoscopic dacryo–cystorhinostomy are encouraging. They can favourably affect wound healing and result in larger rhinostomy size/ostium. Mitomycin–C is safe and effective adjunct in endoscopic dacryo–cystorhinostomy procedure.