{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T14:13:24Z","timestamp":1784297604966,"version":"3.55.0"},"reference-count":23,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2013,6,10]],"date-time":"2013-06-10T00:00:00Z","timestamp":1370822400000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Otolaryngology"],"published-print":{"date-parts":[[2013,6]]},"abstract":"Background<\/jats:title>Mitomycin C<\/jats:styled-content> has recently been used to prevent nasal synechiae and sinus ostium stenosis after endoscopic sinus surgery.<\/jats:p><\/jats:sec>Objective of review<\/jats:title>To compare nasal synechiae rate between topical M<\/jats:styled-content>itomycin C<\/jats:styled-content> and saline or no treatment.<\/jats:p><\/jats:sec>Type of review<\/jats:title>Systematic review and meta\u2010analysis.<\/jats:p><\/jats:sec>Data sources<\/jats:title>MEDLINE<\/jats:styled-content>, SCOPUS<\/jats:styled-content>, and Cochrane Register of Controlled Trials databases were used to identify studies up to January 2013.<\/jats:p><\/jats:sec>Evaluation method<\/jats:title>Data were independently extracted by two reviewers (PN<\/jats:styled-content> and KT<\/jats:styled-content>). Studies which compared topical M<\/jats:styled-content>itomycin C<\/jats:styled-content> with control where the outcomes of interest were nasal synechiae or sinus ostium stenosis were included. Baseline study characteristics, quality of study, numbers of patients between treatment and control groups, outcomes, and adverse events were extracted. A multivariate meta\u2010analysis was separately applied for each outcome (nasal synechiae and maxillary sinus ostium stenosis).<\/jats:p><\/jats:sec>Results<\/jats:title>Among 11 included studies, most studies used Mitomycin C dose of 0.4\u20130.5\u00a0mg\/mL 1\u20135\u00a0mL in the middle meatus for 5\u00a0min duration. Eight studies reported synechiae with 281 and 281 nasal cavities received M<\/jats:styled-content>itomycin C<\/jats:styled-content> and saline, respectively. For outcome of nasal synechiae, a multivariate meta\u2010analysis suggested that M<\/jats:styled-content>itomycin C<\/jats:styled-content> was associated with a 66% (RR\u00a0=\u00a00.34, 95% CI: 0.18\u20130.65) lower risk of nasal synechiae with moderate heterogeneity (I<\/jats:italic>2<\/jats:sup>\u00a0=\u00a043%, 95% CI: 0\u201377%). Subgroup analyses by age and history of revision could reduce the degree of heterogeneity. Mitomycin C<\/jats:styled-content> benefits were found in subgroups of age\u00a0\u2264\u00a040\u00a0years (RR\u00a0=\u00a00.27, 95% CI: 0.05\u20131.50) and patients without any history of revision (RR\u00a0=\u00a00.19, 95% CI: 0.06\u20130.58). Five studies with 134 and 140 nasal cavities for M<\/jats:styled-content>itomycin C<\/jats:styled-content> and saline were included in pooling of maxillary sinus ostium stenosis. Mitomycin C<\/jats:styled-content> was associated with 74% (RR\u00a0=\u00a00.26, 95% CI: 0.12\u20130.54) lower risk of maxillary sinus ostium stenosis when compared with saline with low heterogeneity (I<\/jats:italic>2<\/jats:sup>\u00a0=\u00a05%, 95% CI: 0\u201385%). There was no evidence of publication bias for both poolings.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>Applying Mitomycin C topically after endoscopic sinus surgery could reduce the risk of nasal synechiae and maxillary sinus ostium stenosis in short term by 66% and 74%, respectively. The treatment effects may be more beneficial in patients aged 40\u00a0years or younger or in patients without history of revision. However, our results were based on pooling trials with questionable methodological quality. Further trials with good research methodology and long\u2010term follow\u2010up should be conducted to confirm our results.<\/jats:p><\/jats:sec>","DOI":"10.1111\/coa.12114","type":"journal-article","created":{"date-parts":[[2013,4,1]],"date-time":"2013-04-01T07:44:39Z","timestamp":1364802279000},"page":"198-207","source":"Crossref","is-referenced-by-count":16,"title":["Efficacy of Mitomycin C for postoperative endoscopic sinus surgery: a systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"38","author":[{"given":"P.","family":"Numthavaj","sequence":"first","affiliation":[{"name":"Section for Clinical Epidemiology and Biostatistics Faculty of Medicine, Ramathibodi Hospital Mahidol University Bangkok Thailand"},{"name":"Department of Otolaryngology Faculty of Medicine Ramathibodi Hospital Mahidol University Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Tanjararak","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Faculty of Medicine Ramathibodi Hospital Mahidol University Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Roongpuvapaht","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Faculty of Medicine Ramathibodi Hospital Mahidol University Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"McEvoy","sequence":"additional","affiliation":[{"name":"Centre for Clinical Epidemiology and Biostatistics The University of Newcastle Newcastle NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Attia","sequence":"additional","affiliation":[{"name":"Centre for Clinical Epidemiology and Biostatistics The University of Newcastle Newcastle NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Thakkinstian","sequence":"additional","affiliation":[{"name":"Section for Clinical Epidemiology and Biostatistics Faculty of Medicine, Ramathibodi Hospital Mahidol University Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,6,10]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOO.0b013e328011bcae"},{"key":"e_1_2_9_3_1","first-page":"141","article-title":"Mitomycin, a new antibiotic from Streptomyces. 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