Endoscopic Ostium Assessment Following Endonasal Dacryocystorhinostomy with Mitomycin C Application

Abstract

Aim: The aim of the study is to visualize the patency and measure the ostium size at the end of Endonasal DCR with mitomycin C (MMC) versus control and to assess the role of Mitomycin C in maintaining patency of nasolacrimal drainage system. Design: Prospective randomized controlled study Participants: Sixty patients who consented for this study was subjected to endonasal DCR and randomised into 2 groups (30 cases with mitomycin – C and 30 cases without MMC). Methods: Mitomycin-C 0.2mg/ml was applied intra-operatively for 5mins to the ostium site at the end of endonasal DCR in the MMC group. Results: In the mitomycin C group, 97% (29/30) of the ostium was found to be patent while in the control group 87% (26/30) were found to be patent. It was found that there was statistically significant difference in the osteotomy surface area between the MMC group and control group (p < 0.001).Both groups had a mean follow-up of 24-36 months. No complications were associated with use of Mitomycin-C. Conclusion: Intra-operative use of Mitomycin- C in endonasal DCR is safe and effective in maintaining the ostium size and thereby increasing the success rate.

Keywords

• Chronic dacryocystitis
• Endonasal endoscopic dacryocystorhinostomy
• Mitomycin C
• Ostium