TOPICAL MITOMYCIN C IN PREVENTION OF ADHESIONS FORMATION AFTER FUNCTIONAL ENDOSCOPIC SINUS SURGERY

Objective: This Study aimed to assess the efcacy of topical application of Mitomycin C as two doses, intraoperative and 3 weeks later, in the prevention of adhesions formation after functional endoscopic sinus surgery. Materials and Methods: A prospective randomized clinical trial conducted in Otorhinolaryngology Department, Tishreen University Hospital, Lattakia, Syria, between July 2021 and July 2022. The study included 62 patients underwent bilateral functional endoscopic sinus surgery (Fess) for chronic rhinosinusitis with or without polyps. A cotton pledget soaked with 1ml of mitomycin C (0,8 mg/ml) was randomly applied in the middle meatus of one nasal cavity (study side) for 5 minutes and a second pledget soaked with 1ml normal saline was applied in the contralateral side (control side) at the completion of surgery and repeated 3 weeks later. Patients were followed for 3 months after surgery (1st week ,3rd week ,6th month ,3rd months) and assessed endoscopically for any adhesion formation and the side of it. Lund_ Kennedy endoscopic score was recorded and compared between the two sides. Results: Adhesions were observed in 11 patients (17,74%), two patients had bilateral adhesions. 4 adhesions were in the mitomycin C side (6,45%) and 11 in the control side (17,74%) but this difference was not statistically signicant (p value =0.55). According to the endoscopic score there was a statistically signicant difference between the two groups especially after the second application of mitomycin C (p value <0,0001). Conclusion: Topical application of Mitomycin C intra_ and postoperative may reduce the incidence of adhesions after functional endoscopic sinus surgery in the dose used in our study, and improve the mucosal healing.