Mitomycin-C Prevents Post-Operative Adhesions after Endoscopic Nasal Surgery

Purpose: To assess the role of mitomycin-c (MMC) in preventing synechia formation and ostial stenosis following endoscopic nasal surgery. Patients and methods: This is a prospective comparative study on a total of thirty patients of different ages including both sexes. Patients were divided in two groups (A and B, 15 each). Group (A) had FESS operation and group (B) had partial inferior turbinectomy. In Group (A) 15 primary FESS procedures were performed in 15 patients: nine patients had bilateral pansinusitis, and six cases had bilateral nasal polyposis. MMC was applied at the site of middle meatal antrostomy on one side and the contra-lateral side served as the control. In Group (B), 15 endoscopic bilateral partial inferior turbinectomy was performed in 15 patients. MMC was applied between residual of right inferior turbinate and the septum, while the contra-lateral side served as a control. The data were analyzed after two months of follow up. Results: One patient (6.7%) had adhesion at Rt. Side and seven patients (46.7%) had adhesions at Lt. Side, while 14 patients (93.3%) had no adhesion at Rt. Side and eight patients (53.3%) had no adhesion on Lt. Side (P=0.013). In Group (B), three patients (20%) had adhesion at Rt. Side and nine patients (60%) had adhesions at Lt. Side, while 12 patients (80%) had no adhesion at Rt. Side and 6 patients (40%) had no adhesion on Lt. Side (P=0.025). Conclusion: Topical use of MMC is safe and beneficial in decreasing adhesion formation after endoscopic nasal surgery.