MITOMYCIN-C AS PANACEA FOR PREVENTION OF ADHESION FORMATION AFTER FUNCTIONAL ENDOSCOPIC SINUS SURGERY (FESS/ESS) IN CASES OF CHRONIC RHINOSINUSITIS (CRS)
*Dr. A.S. Harugop, M.S. ENT, P.hD, Dr. R.S. Mudhol, M.S ENT, DLO, Dr. Dharmishtha R. Kaku, MBBS and Dr. Javali. S.B. M.Sc, M.Phil, P.hD
ABSTRACT
Objective: To determine the beneficial effect of topical application of Mitomycin-C at the conclusion of FESS in reduction of the incidence and grade of postoperative adhesion formation. Study Design: Prospective hospital based interventional study. Materials and Methods: Between May2011-July2014, a total of 150 patients underwent FESS. Among these, 75 were included in Group A (Interventional-MMC) and 75 in group B (Control-Saline). The group-A underwent topical MMC application and Group-B normal saline application at the end of FESS. In both Group A and Group B, the age group varied from 17-66 years and there were 30 unilateral and 45 bilateral sides -thus making a total of 120 operative sides in each group. Patients were followed up weekly for first two weeks and at end of 1st, 2nd and 3rd month. Rate of adhesions were recorded and graded as per types A-D. Results: Rate of adhesions at first follow up was 28.33% and 60.83%, at second follow up 15.83% and 36.67% and at third follow up 5% and 25% in Group A and group B respectively. The expected difference in the rate of adhesions between the groups was 11% as per the research hypothesis. The observed difference of 20% was higher than the expected one strengthening the research hypothesis. On comparison, the grades of adhesions in group A were significantly less than group B (p<0.05). Conclusions: Topical application of Mitomycin-C at the conclusion of FESS/ESS has a role in prevention of adhesion formation and reduces both the incidence as well as the grade of adhesion.
Keywords: Chronic rhino- sinusitis, Synechiae, grade of adhesions, FESS/ESS, Topical Mitomycin-C.
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