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Evidence-based applications of mitomycin C in the nose.
MedLine Citation:
PMID:  20851503     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: Mitomycin C (MMC) is an antimitotic drug that may, when applied topically, prevent postoperative stenosis. Its use remains controversial. This review aims to provide otolaryngologists with an update of the evidence on the applications of this agent in the nose and sinuses.
METHODS: A systematic review was performed. Inclusion criteria were as follows: English literature, original articles, reviews, and case series. Exclusion criteria were as follows: animal and in vitro studies, nonendoscopic and nonsinonasal applications of MMC, and external lacrimal surgery. Studies that used other ways of dilating stenoses in conjunction with MMC were excluded.
RESULTS: Out of 48 studies published, 9 fulfilled our inclusion criteria, totaling 322 patients. Eighty-five percent were primary and 15% were revision cases. Follow-up ranged from 1 to 42 months. Main outcome measures used were endoscopic examination, anatomical measurements, radiological scoring systems, dye tests, and subjective symptom resolution. Main overall outcomes from studies where extrapolation of data was feasible were (1) patency rate, which ranged from 63% to 94.4% (mean, 81.3%); (2) adhesions: 5.1% (MMC) vs 15.05 (control); and (3) stenosis: 14.05% (MMC) vs 32.6% (control).
CONCLUSIONS: There appears to be a favorable short-term effect of MMC, but no robust evidence regarding long-term prevention of restenosis. Larger homogenous and multicenter randomized trials are needed to assess the long-term effects of MMC in sinonasal surgery.
Authors:
Peter D Karkos; Samuel C Leong; Andy Sastry; Assimakis D Assimakopoulos; Andrew C Swift
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Publication Detail:
Type:  Journal Article     Date:  2010-09-20
Journal Detail:
Title:  American journal of otolaryngology     Volume:  32     ISSN:  1532-818X     ISO Abbreviation:  Am J Otolaryngol     Publication Date:    2011 Sep-Oct
Date Detail:
Created Date:  2011-08-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8000029     Medline TA:  Am J Otolaryngol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  422-5     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Elsevier Inc. All rights reserved.
Affiliation:
Department of Otolaryngology, University Hospital Aintree, Bristol, UK; Liverpool, Alder Hey Children's Hospital, Bristol, UK.
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