Comparison of Mitomycin-C with Normal Saline in preventing Synechiae formation in patients undergoing Endoscopic Sinus Surgery
DOI:
https://doi.org/10.47489/szmc.v40i3.728Keywords:
Endoscopic sinus surgery, Mitomycin-C, Synechiae, Chronic rhinosinusitisAbstract
Background: Chronic rhinosinusitis (CRS) is a prevalent condition affecting 5% to 12% of the population, often necessitating endoscopic sinus surgery (ESS) for treatment. Postoperative synechiae formation is a common complication of ESS, potentially leading to recurrent infections and impaired healing. Mitomycin-C (MMC), an antineoplastic agent known for its anti-fibrotic properties, has been proposed as a preventive agent against synechiae formation. .
Objective: This study aimed to evaluate the efficacy of MMC in reducing postoperative synechiae formation compared to normal saline
Methods: This prospective randomized control trail study was conducted at Ahmed Medical Center Rawalpindi over a six-month period, including 60 patients with CRS or nasal polyps. Patients were randomly assigned to two groups: Group A (MMC; n=30) received a topical MMC solution applied to the middle meatus after ESS, and Group B (normal saline; n=30) received normal saline. Synechiae formation was assessed four weeks postoperatively. Data were analyzed using SPSS version 26, with chi-square tests employed for statistical analysis.
Results: Postoperative synechiae occurred in 2/30 (6.7%) of the Mitomycin-C group versus 3/30 (10%) of the saline group (RR=0.67, 95% CI 0.12–3.71, p=0.64) was observed in 8.3% of the study population. In Group A, 2 patients (6.7%) developed synechiae, compared to 3 patients (10%) in Group B. The difference in synechiae formation between the groups was not statistically significant (p = 0.64).
Conclusion: Although MMC slightly reduced synechiae formation compared to normal saline, the difference was not statistically significant. This suggests that MMC may not provide a substantial advantage in preventing synechiae in routine ESS. Further research with larger sample sizes and varying MMC concentrations is necessary to clarify its role in synechiae prevention.
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