Mitomycin-C in Endoscopic Dacryocystorhinostomy

비내누낭비강문합술에서 Mitomycin-C의 효과

Background and Objectives： The most common cause of the failure of endoscopic dacryocystorhinostomy is closure of the osteotomy site due to granulation or adhesion. We used mitomycin-C, an antineoplastic antibiotic agent, soaking over the osteotomy site to suppress fibrous proliferation and scar formation during the endoscopic dacryocystorhinostomy. Materials and Methods : A total of 20 Patients diagnosed with nasolacrimal duct obstruction were assigned randomly to either a mitomycin-C group or a control group. Endoscopic dacryocystochinostnmy has been used in both groups. In the mitomycin-C group, a piece of merocel soaked with 0.2 mg/ml mitomycin-C was applied to the osteotomy site and then after 30 minutes was removed. Results : All patients in the mitomycin-C group remained symptom free after removal of their silicone tube (100% success), and there were two patients in the control group who had recurrent epiphora (67% success). In the mitomycin-C group, the average surface area of the osteotomy at the end of the sixth postoperative month was 4.1 $\textrm{mm}^2$, whereas that of the control group was 2.5 $\textrm{mm}^2$. Neither serious systemic nor local toxicity were noted in the mitomycin-C group. Conclusion : Intraoperative mitomycin-C may possibly improve success rates over the endoscopic dacryocystorhinostomy procedure.