Tabaee Abtin, Brown Seth M, Anand Vijay K
Department of Otorhinolaryngology, Weill Medical College of Cornell University, New York, NY 10021, USA.
Curr Opin Otolaryngol Head Neck Surg. 2007 Feb;15(1):40-3. doi: 10.1097/MOO.0b013e328011bcae.
Mitomycin C has been used successfully in various ophthalmologic and, more recently, otolaryngologic procedures. Its modulation of fibroblast activity allows for decreased scarring and fibrosis. Several recent trials have examined the efficacy of mitomycin C in reducing synechia and stenosis following endoscopic sinus surgery.
Basic science studies using fibroblast cell lines have demonstrated a dose-dependent suppression of activity with the use of mitomycin C. This is further supported by animal studies that have shown lower rates of maxillary ostial restenosis following application of mitomycin C. No human trial, however, has demonstrated a statistically significant impact of mitomycin C on the incidence of postoperative synechia or stenosis following sinus surgery. The limitations of the literature are discussed.
The antiproliferative properties of mitomycin C may theoretically decrease the incidence of synechia and stenosis following endoscopic sinus surgery. Although this is supported by basic science studies and its successful use in other fields, the clinical evidence to date has not shown the application of mitomycin C to be effective in preventing stenosis after endoscopic sinus surgery. Future prospective studies are required before definitive conclusions can be made.
丝裂霉素C已成功应用于各种眼科手术，最近也应用于耳鼻喉科手术。它对成纤维细胞活性的调节作用可减少瘢痕形成和纤维化。最近的几项试验研究了丝裂霉素C在内镜鼻窦手术后减少粘连和狭窄的疗效。
使用成纤维细胞系的基础科学研究表明，使用丝裂霉素C可对其活性产生剂量依赖性抑制。动物研究进一步支持了这一点，这些研究表明应用丝裂霉素C后上颌窦口再狭窄率较低。然而，尚无人体试验证明丝裂霉素C对鼻窦手术后粘连或狭窄的发生率有统计学上的显著影响。文中讨论了现有文献的局限性。
理论上，丝裂霉素C的抗增殖特性可能会降低内镜鼻窦手术后粘连和狭窄的发生率。尽管基础科学研究及其在其他领域的成功应用支持了这一点，但迄今为止的临床证据并未表明丝裂霉素C在预防内镜鼻窦手术后狭窄方面有效。在得出明确结论之前，需要进行未来的前瞻性研究。
