Abstract
Synechia is the most frequent complication after sinus surgery and has been reported in up to 36% of cases. Several types of materials have been used to reduce the incidence of synechia, including Mitomycin C (MMC). ObjectiveThis prospective study aimed to assess the effectiveness of topical MMC in the prevention of synechia after sinus surgery in humans. MethodsAt the end of surgery, MMC solution (1.0 mg/ml) was topically applied randomly to one of the middle meatuses (MMC group) of 14 patients while saline solution was applied to the contralateral meatus (control group). The author remained blind to the medicated side. Synechiae were classified as partial or total. ResultsThree patients had middle meatus synechia in the MMC group (21.43%) versus nine (64.29%) in the control group (p = 0.054). In the MMC group, all three middle meatus synechia were partial, while in the control group there were four partial (28.57%) and five total (35.71%) cases of synechia (p = 0.025). ConclusionsMitomycin C was not effective in preventing middle meatus synechia, but reduced the probability of total synechia formation.
Highlights
The treatment of choice for refractory chronic rhinosinusitis is functional endoscopic sinus surgery (FESS), one of the most frequently performed procedures in the ENT practice
At the end of surgery, Mitomycin C (MMC) solution (1.0 mg/ml) was topically applied randomly to one of the middle meatuses (MMC group) of 14 patients while saline solution was applied to the contralateral meatus
In the MMC group, all three middle meatus synechia were partial, while in the control group there were four partial (28.57%) and five total (35.71%) cases of synechia (p = 0.025)
Summary
The treatment of choice for refractory chronic rhinosinusitis is functional endoscopic sinus surgery (FESS), one of the most frequently performed procedures in the ENT practice. The most frequent events related to the latter cause are synechia and ostium stenosis (27% in maxillary sinuses and 25% in frontal sinuses)[3,4]. Postoperative synechia is the most frequently reported complication in the literature, found in between 11% and 36% of the cases. Revision surgery is required in 1% to 2% of the cases[5,6,7,8]. A review on 182 FESS patients revealed that the only findings related to little clinical improvement were fibrosis in medial antrostomies and in the ethmoidal region[3]
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