Baradaranfar Mohammad-Hossein, Khadem Jalal, Taghipoor Zahir Shokooh, Kouhi Ali, Dadgarnia Mohammad Hossein, Baradarnfar Amin
Department of Otolaryngology, Head and Neck Surgery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Acta Med Iran. 2011;49(3):131-5.
Adhesions after endoscopic sinus surgery (ESS) are a potential cause of surgical failure. Mitomycin-C (MMC) is recently proposed as a solution for these adhesions. This study was performed to investigate the effect of Mitomycin C in reducing scar formation and adhesion in the nasal mucosa after endoscopic nasal surgery. This double blind randomized clinical trial study was performed on 37 patients with bilateral chronic rhinosinusitis. At the end of ESS, randomly impregnated mesh with MMC was placed in one side and another mesh impregnated with saline in the opposite side for 5 minutes. Patients were followed at least for three months, and the results of diagnostic endoscopy were recorded. Post operative adhesion occurred in 12 (32.4%) patients (2 bilateral/10 unilateral). Among total of 14 adhesions, 4 (10.8%) were in the MMC side and 10 (27%) in the control side. This differences was close to statistically significant (P=0.058). MMC may reduce adhesions after ESS, but further studies with different doses, sample size and frequent use of topical MMC is recommended.
鼻内镜鼻窦手术（ESS）后的粘连是手术失败的一个潜在原因。丝裂霉素-C（MMC）最近被提议作为解决这些粘连的方法。本研究旨在探讨丝裂霉素C在内镜鼻窦手术后减少鼻黏膜瘢痕形成和粘连的效果。这项双盲随机临床试验研究对37例双侧慢性鼻-鼻窦炎患者进行。在ESS结束时，将随机浸渍有MMC的网片放置在一侧，另一侧放置浸渍有生理盐水的网片5分钟。对患者至少随访三个月，并记录诊断性鼻内镜检查结果。术后粘连发生在12例（32.4%）患者中（2例双侧/10例单侧）。在总共14处粘连中，4处（10.8%）在MMC侧，10处（27%）在对照侧。这种差异接近具有统计学意义（P=0.058）。MMC可能会减少ESS后的粘连，但建议进一步开展不同剂量、样本量以及频繁使用局部MMC的研究。
