Role of Mitomycin C in Endoscopic Management of Nasolacrimal Duct Obstruction

Objective: To study the effects of mitomycin C in prevention of recurrent stenosis adhesion formation in endoscopic management of obstructed nasolacrimal duct. Study Design: Quasi experimental design. Place & Duration: The study was conducted at the department of ENT-Head & Neck Surgery, Dow University of Health Sciences, Karachi from September 2002 to September 2012. Patients were selected from different hospitals including Faiz-e-Aam Hospital, Mid City Hospital, National Medical Centre and Civil Hospital, Karachi. Subject & Methods: Clinical records of 82 patients, who were diagnosed to have nasolacrimal duct obstruction and managed by transnasal endoscopic approach, were reviewed. Participants were randomly divided in two groups depending upon application of mitomycin C intra-operatively. Demographic data was collected including age, gender, associated nasal pathologies, or concomitant nasal surgery performed, post operative relief of epiphora and complications if any, were recorded on institutional approved performa. Patients were followed up for 3 to 6 months. Surgical success was defined by complete relief from epiphora and free drainage of nasolacrimal duct, after 3 and 6 months of follow up. Results: Mitomycin C was applied in more than half of our patients 54.9 % (n=45/82). Out of which 93.3% (n=42/45) were completely relieved from epiphora within six months, and only 6.6% (n=3/45) patients had developed synechiae. In contrast, 45.1 % (n=37) patient in whom mitomycin C was not applied, complete recovery from symptoms was observed in 78.3% (n=29/37), and 21.6% (n=8/37) patient had developed nasal synechiae. The results were statistically analysed using Chi-Square test.