***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Purpose Dacryocystorhinostomy ( DCR ) is widely accepted as the procedure of choice for surgical correction of lacrimal drainage system obstruction distal to common canaliculus in adulthood . The success rate of DCR has been reported to be from 63 % to 99 % . DCR failure has been attributed to membranous occlusion of the rhinostomy site caused by soft tissue scarring . More recently , use of mitomycin C ( MMC ) has been described in lacrimal drainage surgery . The beneficial effect of MMC as a surgical adjunct is thought to be related to its potent inhibition of fibroblast proliferation . Methods To improve the success rate of DCR , the authors used MMC as an adjunct to surgery in 130 patients with nasolacrimal duct obstruction undergoing lacrimal surgery . They were assigned r and omly into a MMC DCR group and a regular DCR group ( control group ) . Results The mean age of the MMC group was 40 ± 15 years and that of the control group was 42 ± 16 years . The st and ard surgical techniques of an external DCR were used in all patients of both groups . Patients were followed for 6 months . The authors evaluated the patients with subjective symptoms ( improvement in tearing ) and objective findings such as the height of tear meniscus , fluorescein dye test , and patency at the time of irrigation . There was no significant difference in the age between the two groups ( p=1.00 ) . Six patients in the mitomycin group were symptomatic after 6 months ' follow-up ; probe and irrigation showed non-patency of lacrimal system . The success rate in the MMC group was therefore 90.5 % ( 59/65 ) , and in the conventional group it was 92.4 % ( 60/65 ) . No significant difference between the two groups was present ( p=0.75 ) . Conclusions The authors conclude that the use of intraoperative MMC in DCR surgery does not change the success rate of this procedure AIMS To evaluate the long term results of intraoperative mitomycin C application in dacryocystorhinostomy ( DCR ) surgery compared with results of the conventional procedure . METHODS In this prospect i ve r and omised controlled study , a total of 88 eyes diagnosed with acquired nasolacrimal duct obstruction were r and omly divided into a conventional DCR group and a mitomycin C group in which mitomycin C was used during DCR surgery . The surgical procedures in both groups were exactly the same , except that in the patients in the mitomycin C group , a piece of neurosurgical cottonoid soaked with 0.2 mg/ml mitomycin C was applied to the osteotomy site for 30 minutes . The results of the DCR surgeries were evaluated by objective findings such as irrigation and the height of tear meniscus and subjective symptoms by asking patients the condition of tearing improvement . RESULTS Among the 44 eyes in the mitomycin C group , 95.5 % of patients remained totally symptom free after 10 months of follow up ; while in the conventional group , 70.5 % of patients were reported to be symptom free and 18 % of patients to have an improvement in their symptoms . There was a significant difference between these two groups . As far as objective findings were concerned , there were 41 eyes in the mitomycin C group classified as having a normal and one eye with moderate tear meniscus level , compared with 32 eyes and seven eyes , respectively , in the conventional group . There was also a significant difference between these two groups . The non-patency rate in the mitomycin C group is 4.5 % compared with 11.4 % in the conventional group . There were no complications such as abnormal nasal bleeding , mucosal necrosis , or infection except one patient with delayed wound healing . CONCLUSIONS Intraoperative mitomycin C application is effective in increasing the success rate of DCR surgery in st and ard nasolacrimal duct obstruction , and no significant complications result ed from its use OBJECTIVES /HYPOTHESIS To evaluate the efficacy of intraoperative mitomycin C ( MMC ) in endonasal endoscopic dacryocystorhinostomy . STUDY DESIGN R and omized controlled trial . METHODS Fifty patients with primary acquired nasolacrimal duct obstruction were enrolled and r and omly allocated into the treatment and control group . The patients underwent st and ard endonasal endoscopic dacryocystorhinostomy with mucosal flaps and mitomycin C or placebo on each group . The ostium size was measured at 3 months , 6 months , and 12 months to evaluate the effect of mitomycin C and placebo , and the patency of the lacrimal drainage system was assessed . RESULTS There was no statistical significance in the success rate between the MMC group and the control group at 1-year follow-up ( 84.6 % vs.79.2 % , respectively , P = .59 ) . At the 6-month and 12-month visits , the mean ostium size in the MMC group was 10.8 mm(2 ) ( SD = 3.17 ) and 3.0 mm(2 ) ( SD = 1.78 ) , respectively , which were prominently larger than the control group at 7.1 mm(2 ) ( SD = 2.62 ; P < .001 , 95 % CI , 0.84 - 5.45 ) and 1.6 mm(2 ) ( SD = 1.18 ; P = .004 , 95 % CI , 0.49 - 2.38 ) . CONCLUSIONS There was no statistically significant difference in the success rates of both groups , but MMC seems to have a conspicuous effect on the healing process at the ostium Objective To assess the long-term results of intraoperative mitomycin C ( MMC ) in external dacryocystorhinostomy ( EXT-DCR ) . Methods In this prospect i ve r and omized controlled study , 35 patients ( 40 eyes ) with primary acquired nasolacrimal duct obstruction were assigned r and omly into two groups . In the control group , a st and ard EXT-DCR procedure was performed . In the MMC group 0.2 mg/ml MMC was applied to the osteotomy site for 30 min . The results of EXT-DCR in both groups were evaluated by both asking patients about the tearing condition and examining the patency of irrigation at one-year follow up . Results Eighteen ( 90 % ) of the 20 eyes in the MMC group remained totally symptom-free and one eye ( 5 % ) improved ; while 12 ( 60 % ) of 20 eyes in the control group were reported to be symptom-free and five ( 25 % ) of the eyes to have an improvement in the tearing symptoms ( P = 0.087 ) . The success rate in the MMC group was 95 % compared with 85 % in the control group ( P = 0.605 ) . No surgical complications occurred . Conclusions The satisfaction and success rates of the MMC group were higher than those of the control group and no deleterious effect was noted with MMC application , however the differences did not reach statistical significance . Intraoperative MMC application seems to be a safe adjuvant that could help in increasing the success rates of EXT-DCR surgery in primary acquired nasolacrimal duct obstruction , however further studies with larger series are needed to make definite statements PURPOSE The purpose of this study is to observe the effect of intraoperative topical application of mitomycin C ( MMC ) on the results of endoscopic dacryocystorhinostomy . DESIGN This is a prospect i ve , r and omized , controlled , single-blind study . SETTING S Hospitalized treatment was done in a tertiary medical college hospital and research center that deals with a predominantly rural population . PATIENTS Patients with primary acquired postsaccal obstruction causing chronic dacryocystitis were considered . METHODS A total of 38 patients were r and omized into either a mitomycin group or a control group . Both of these groups were subjected to an identical surgical procedure , except that 0.2 mg/dL of MMC was used in the mitomycin group , whereas normal saline was used in the control group . The follow-up period was at least 6 months . An asymptomatic patient with a visible stoma at nasendoscopy and free flow of saline into the nose with lacrimal syringing after 6 months after surgery was used as criteria for defining a successful result . RESULTS The success rate was 82.3 % when MMC was used and 85.7 % among the controls ( P > .05 ) . Granulations , adhesions , and obliterative sclerosis occurred in a similar number of patients of both groups . However , granulations and adhesions did not have a bearing on the success rate in either group . CONCLUSION Mitomycin C did not appear to influence the occurrence of granulations , synechiae , or obliterative sclerosis , nor did it alter the success rate significantly Purpose To assess the effect of mitomycin C on surgical success rate of dacryocystorhinostomy and silicone intubation in patients with improper flaps . Methods The study was a r and omized clinical trial . The patients with indication for dacryocystorhinostomy surgery with silicone intubation ( inappropriate lacrimal sac or nasal mucosal flaps during surgery and /or history of dacryocystitis in the past 3 months ) were r and omly assigned to application of mitomycin C ( 0.02 % ) on surgical flaps ( group A ) or a control group without mitomycin C application ( group B ) . Main outcome measures were subjective symptomatic improvement and result of irrigation test at last follow-up visit . Results The study enrolled 88 patients ( 88 eyes ) ; there were 42 patients in group A and 46 patients in group B. There was an average follow-up of 10 months ( range 6 - 15 months ) following surgery . Significant improvement ( no tearing with patent lacrimal system in irrigation ) was observed in 31 patients ( 73.8 % ) in group A and 32 patients ( 69.6 % ) in group B. There was no statistically significant difference in no improvement ( no change in tearing state and obstruction in irrigation test ) , relative improvement ( decreased tearing and passage of fluid with force in irrigation test ) , and significant improvement rate between the 2 groups of study ( p>0.05 ) . Conclusions Application of mitomycin C on surgical flaps during dacryocystorhinostomy surgery with silicone intubation in patients with improper flaps has no proven beneficial effect on success rate of surgery Objective : To evaluate the role of topical Mitomycin C in Endoscopic Dacryocystorhinostomy ( DCR ) , for the prevention of stomal stenosis . Patients : Thirty patients undergoing endoscopic DCR for chronic dacryocystitis were studied prospect ively . The follow up period was 12 months . Technique : Patients were divided into two groups r and omly . All of them underwent endoscopic DCR .  One group was subjected to topical Mitomycin C application after surgery while the control group was not . Main outcome measures : Postoperative relief of epiphora and endoscopic documentation of the patency of the stoma were the main outcome measures . Results : 80 % cases of the Mitomycin C group and 86.67 % cases of the non Mitomycin C group had long-term successful results . This result is not statistically significant ( p > 0.2 ) . Conclusion : Intraoperative Mitomycin C application does not alter the long-term results in endoscopic DCR . A properly and adequately performed surgery is more vital for successful result PURPOSE To evaluate the efficacy and safety of adjunctive mitomycin-c ( MMC ) during probing in adults with primary nasolacrimal duct ( NLD ) obstruction . METHODS This is a prospect i ve , comparative , r and omized interventional study . A total of 40 adult patients with unilateral epiphora caused by primary NLD obstruction were treated and evaluated . Lacrimal probing and irrigation with adjunctive MMC ( 1 mL of 0.2 mg/mL , once ) in cases and only probing in controls were done . At the end of 3 months , subjective improvement in epiphora and patency on syringing were evaluated . RESULTS Complete subjective improvement in epiphora was found in 15 % of cases as opposed to 0 % in controls , at 3 months of follow-up . Moderate improvement was seen in 25 % of cases as opposed to 5 % of controls . Mild improvement was seen in 25 % of cases as opposed to 35 % in controls . The overall subjective improvement was seen in 65 % of cases as opposed to 40 % in controls . On syringing , NLD was patent in 30 % of cases as opposed to 10 % in controls at 3 months of follow-up , which was not significant . CONCLUSIONS Use of intraoperative MMC improves the success of probing to some extent . Being a minimally invasive procedure , it can be tried in patients who refuse or are not systemically fit for undergoing dacryocystorhinostomy Aims and objectives To compare the outcome of dacryocystorhinostomy surgery with and without the intraoperative use of Mitomycin C. Methods Our study is a prospect i ve comparative case study in which 50 patients of primary acquired nasolacrimal duct obstruction were divided on the basis of r and om sampling into the conventional dacryocystorhinostomy group and the Mitomycin C group in which Mitomycin C 0.2 mg/ml was used intraoperatively . Patients were followed on 1st postoperative day , 1st , 3rd , 6th weeks , 3rd and 6th months . Patient 
    Output:
    
The intraoperative use of MMC is safe and slightly improves the success rate of Ex- or En-DCR .