A study on role of topical application of mitomycin c postoperatively in reducing adhesions/synechiae after FESS in patients with chronic rhinosinusitis: A Randomized controlled trial.
Synechiae formation is a common and undesired complication after functional endoscopic sinus surgery. Mitomycin-c, known for its anti-proliferative and anti-fibroblastic properties holds potential for reducing synechiae and scar tissue formation following endoscopic sinus surgery. This study aims to evaluate the efficacy of topically applied mitomycin-c postoperatively in minimising adhesions and nasal obstruction symptoms using the Lund- Kennedy Endoscopic Scoring and Nasal Obstruction Symptom Evaluation (NOSE) scores.
This double-blind randomised study assessed topical mitomycin-c's efficacy in reducing adhesions post-FESS in 50 chronic rhino-sinusitis patients. Participants who were selected based on Lund-Mackay CT scores underwent functional endoscopic sinus surgery (FESS). The mitomycin-c and saline-soaked nasal packs were placed in middle meatuses either of one in each nasal cavity. Postoperative care included antibiotics, analgesics and saline douching. Outcomes were evaluated at 1, 4 and 12 weeks using the NOSE (nasal obstruction symptom evaluation) questionnaire and Lund-Kennedy scoring to determine mitomycin-c's impact on nasal obstruction and synechiae formation.
The results indicated statistically significant variation between mitomycin-c and control sides in terms of symptoms and endoscopic findings in the first week postoperatively. By the fourth week, the clinical pictures of both sides were nearly identical.
Data suggested that low-dose mitomycin-c significantly reduces adhesions and improves nasal symptoms in the early postoperative period for chronic rhinosinusitis patients. These results align with previous research, supporting mitomycin-c as a valuable adjunctive therapy in sinus surgery. Future studies are recommended to explore varying dosages and application methods for potential differences in outcomes.
This double-blind randomised study assessed topical mitomycin-c's efficacy in reducing adhesions post-FESS in 50 chronic rhino-sinusitis patients. Participants who were selected based on Lund-Mackay CT scores underwent functional endoscopic sinus surgery (FESS). The mitomycin-c and saline-soaked nasal packs were placed in middle meatuses either of one in each nasal cavity. Postoperative care included antibiotics, analgesics and saline douching. Outcomes were evaluated at 1, 4 and 12 weeks using the NOSE (nasal obstruction symptom evaluation) questionnaire and Lund-Kennedy scoring to determine mitomycin-c's impact on nasal obstruction and synechiae formation.
The results indicated statistically significant variation between mitomycin-c and control sides in terms of symptoms and endoscopic findings in the first week postoperatively. By the fourth week, the clinical pictures of both sides were nearly identical.
Data suggested that low-dose mitomycin-c significantly reduces adhesions and improves nasal symptoms in the early postoperative period for chronic rhinosinusitis patients. These results align with previous research, supporting mitomycin-c as a valuable adjunctive therapy in sinus surgery. Future studies are recommended to explore varying dosages and application methods for potential differences in outcomes.