Evaluation of Role of Mitomycin C in the Cases of Nasolacrimal Duct Blockage Undergoing Endoscopic Dacryocystorhinostomy.

Abstract

Dacryocystorhinostomy is a common surgical procedure done for the treatment of obstruction of the lacrimal sac or nasolacrimal duct. Adjunctive use of a wound healing inhibitor like Mitomycin C is considered to minimize the risk of complications and increase the success rate of endoscopic endonasal DCR. The current study is aimed to compare the results of endoscopic DCR without silicon stents with or without Mitomycin C and to see for any complications resulting from the surgery. This was a prospective study carried out in the department of Otorhinolaryngology at Safdarjung Hospital, New Delhi from February 2015 to September 2017. Out of the 30 patients who were included in the study, 15 underwent endoscopic DCR without the application of Mitomycin C (Group I) and the remaining 15 with application of Mitomycin C without using stents (Group II). The main criteria for success were the resolution of epiphora and patency on lacrimal irrigation. Success rate in Group I was 86.67% as compared to Group II where the success rate was 93.33%. There were two failures in Group I (13.33%) whereas one failure in Group II (6.66%). More complications were noted in Group I (granulations 13.33%, synechiae 13.33%, persistent epiphora 13.33%) than in Group II (granulations 13.33%, synechiae 6.67%, persistent epiphora 6.67%). To conclude, we have found topical Mitomycin C as a safe and effective means of preventing adhesions and ostium closures in patients undergoing endoscopic DCR.