Abstract：
OBJECTIVE: To study the effect of dose-adjusted mitomycin-c (MMC) on the recurrence rate of choanal atresia (CA), and the complication rate associated with this concentration.
METHODS: This prospective cohort study was conducted between May 2012 and March 2020 at a tertiary referral center. It included patients of all ages who were diagnosed with CA and scheduled to undergo surgical repair. The MMC group received 4.0 mg/mL of topical MMC. Both groups were followed up for the surgical outcomes and complication rates.
RESULTS: Twenty-one patients (15 females) underwent 25 CA repair procedures. The mean age was 44.85 months (standard deviation = 72.85). MMC was used in 12 (57.1%) of 21 patients. Revision CA repair was warranted in three of the nine patients who did not receive topical MMC compared to one of the 12 patients who received topical MMC. The MMC group required 1.08 ± 0.29 surgeries (range, 1-2), whereas the non-MMC group required 1.44 ± 0.73 surgeries (range, 1-3). Functional success was achieved in 17 (81%) patients who remained symptom-free until their last follow-up visit.
CONCLUSIONS: High-concentration MMC was considered safe in the pediatric and adult populations. Although high-concentration MMC could reduce the need for revision surgery, further studies are required to determine whether the effect is significant in a larger sample population.
METHODS: This prospective cohort study was conducted between May 2012 and March 2020 at a tertiary referral center. It included patients of all ages who were diagnosed with CA and scheduled to undergo surgical repair. The MMC group received 4.0 mg/mL of topical MMC. Both groups were followed up for the surgical outcomes and complication rates.
RESULTS: Twenty-one patients (15 females) underwent 25 CA repair procedures. The mean age was 44.85 months (standard deviation = 72.85). MMC was used in 12 (57.1%) of 21 patients. Revision CA repair was warranted in three of the nine patients who did not receive topical MMC compared to one of the 12 patients who received topical MMC. The MMC group required 1.08 ± 0.29 surgeries (range, 1-2), whereas the non-MMC group required 1.44 ± 0.73 surgeries (range, 1-3). Functional success was achieved in 17 (81%) patients who remained symptom-free until their last follow-up visit.
CONCLUSIONS: High-concentration MMC was considered safe in the pediatric and adult populations. Although high-concentration MMC could reduce the need for revision surgery, further studies are required to determine whether the effect is significant in a larger sample population.
摘要：
目的：研究剂量调整的丝裂霉素-c（MMC）对后鼻孔闭锁（CA）复发率的影响，以及与这种浓度相关的并发症发生率。
方法：这项前瞻性队列研究于2012年5月至2020年3月在三级转诊中心进行。它包括被诊断为CA并计划接受手术修复的所有年龄段的患者。MMC组接受4.0mg/mL局部用MMC。对两组患者的手术效果和并发症发生率进行随访。
结果：21名患者（15名女性）接受了25例CA修复手术。平均年龄为44.85个月(标准偏差=72.85)。21例患者中有12例（57.1%）使用MMC。与接受局部MMC的12例患者中的1例相比，未接受局部MMC的9例患者中有3例需要进行CA修复。MMC组需要进行1.08±0.29次手术（范围，1-2),而非MMC组需要1.44±0.73手术(范围，1-3).17名（81％）患者在最后一次随访之前保持无症状状态，实现了功能成功。
结论：高浓度MMC在儿童和成人人群中被认为是安全的。虽然高浓度MMC可以减少翻修手术的需要，需要进一步的研究来确定这种影响在更大的样本人群中是否显著.
方法：这项前瞻性队列研究于2012年5月至2020年3月在三级转诊中心进行。它包括被诊断为CA并计划接受手术修复的所有年龄段的患者。MMC组接受4.0mg/mL局部用MMC。对两组患者的手术效果和并发症发生率进行随访。
结果：21名患者（15名女性）接受了25例CA修复手术。平均年龄为44.85个月(标准偏差=72.85)。21例患者中有12例（57.1%）使用MMC。与接受局部MMC的12例患者中的1例相比，未接受局部MMC的9例患者中有3例需要进行CA修复。MMC组需要进行1.08±0.29次手术（范围，1-2),而非MMC组需要1.44±0.73手术(范围，1-3).17名（81％）患者在最后一次随访之前保持无症状状态，实现了功能成功。
结论：高浓度MMC在儿童和成人人群中被认为是安全的。虽然高浓度MMC可以减少翻修手术的需要，需要进一步的研究来确定这种影响在更大的样本人群中是否显著.
