The Effect of Mitomycin C in Middle Meatal Antrostomy Site

Kim, Seon Tae; Lee, Beob Yong; Ko, Sang Hyun; Chung, Yoo Sam; Cho, Chang Hyun; Park, Jung Soo; Cha, Heung Eog

Abstract

BACKGROUND AND OBJECTIVE: Adhesion and stenosis are important in causing poor results of sinus surgery. Mitomycin C (MMC) is an antibiotic-antineoplastic agent that decreases fibroblast proliferation and scar formation. This study was designed to observe the effect of intraoperative application of mitomycin C on the size of the antrostomy site and mucociliary clearance rate after an endoscopic sinus surgery.
MATERIALS AND METHODS
A total 20 patients diagnosed with chronic sinusitis with nasal polyp were used. After middle meatal antrostomy, a piece of merocel soaked with 0.04 mg/mL MMC 1.5 mL was applied on right antrostomy site for 5 minutes. Left antrostomy site was used as control without applying MMC. The antrostomy size was measured by using gauze instrument under endoscopy at operation, 1, 3 and 6 months after surgery. Mucocilliary clearance rate was assessed by saccharine time test after 2 weeks, 1, 3 and 6 month.
RESULTS
The MMC group has showed lower incidence of stenosis, granulation and adhesion than the control group. At 1 month, the percentage of remaining antrostomy size was 61.6+/-31.6% in MMC group, whereas that of the control group was 46.9+/-23.3%. There was a significant difference in the antrostomy size between the two groups at 1 month, but there was no significant difference at 3 and 6 month. The saccharine time test between the two groups showed no significant difference after operation.
CONCLUSION
The use of MMC will improve the success rate of sinus surgery if it is used as adjuvant therapy after antrostomy. Further study will be needed on the duration of application time, concentration of MMC and method.