Skip to main content
NCBI home page
Skull Base Surgery logoLink to Skull Base Surgery
. 1996 Jul;6(3):137–140. doi: 10.1055/s-2008-1058636

Skull Base Cerebrospinal Fluid Leakage Control with a Fibrin-Based Composite Tissue Adhesive

Jack P Rock, David H Sierra, Frederico Castro-Moure, Feng Jiang
PMCID: PMC1656570  PMID: 17170969

Abstract

Cerebrospinal fluid (CSF) leaks can be responsible for significant patient morbidity and mortality. While the majority of leaks induced after head trauma will seal without intervention, spontaneous or surgically-induced leaks often require operative repair. Many modifications on standard surgical technique are available for repair of CSF fistulae, but none assures adequate closure. We have studied the efficacy of a novel fibrin-based composite tissue adhesive (CTA) for closure of experimentally-induced CSF leaks in rats. Fistulae were created in two groups of animals. Two weeks after creation of the leaks, the animals were sacrificed and analyzed for persistence of leak. A 58% leakage rate was noted in the control group (n = 12), and no leaks were noted in the experimental group closed after application of CTA to the surgical defect followed by skin closure (n = 11). Comparing the control group to the experimental group, results were statistically significant (p = 0.015). These data suggest that CTA may be effective as an adjunct for the closure of CSF fistulae.

Full text

PDF
137

Images in this article

138Figure 2
on p.138
139Figure 3
on p.139

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Cain J. E., Jr, Dryer R. F., Barton B. R. Evaluation of dural closure techniques. Suture methods, fibrin adhesive sealant, and cyanoacrylate polymer. Spine (Phila Pa 1976) 1988 Jul;13(7):720–725. [PubMed] [Google Scholar]
  2. Cain J. E., Jr, Rosenthal H. G., Broom M. J., Jauch E. C., Borek D. A., Jacobs R. R. Quantification of leakage pressures after durotomy repairs in the canine. Spine (Phila Pa 1976) 1990 Sep;15(9):969–970. doi: 10.1097/00007632-199009000-00024. [DOI] [PubMed] [Google Scholar]
  3. KLINE D. G., HAYES G. J. AN EXPERIMENTAL EVALUATION OF THE EFFECT OF A PLASTIC ADHESIVE, METHYL 2-CYANOACRYLATE, ON NEURAL TISSUE. J Neurosurg. 1963 Aug;20:647–654. doi: 10.3171/jns.1963.20.8.0647. [DOI] [PubMed] [Google Scholar]
  4. Nishihira S., McCaffrey T. V. The use of fibrin glue for the repair of experimental CSF rhinorrhea. Laryngoscope. 1988 Jun;98(6 Pt 1):625–627. doi: 10.1288/00005537-198806000-00009. [DOI] [PubMed] [Google Scholar]
  5. Park J. I., Strelzow V. V., Friedman W. H. Current management of cerebrospinal fluid rhinorrhea. Laryngoscope. 1983 Oct;93(10):1294–1300. doi: 10.1002/lary.1983.93.10.1294. [DOI] [PubMed] [Google Scholar]
  6. Shaffrey C. I., Spotnitz W. D., Shaffrey M. E., Jane J. A. Neurosurgical applications of fibrin glue: augmentation of dural closure in 134 patients. Neurosurgery. 1990 Feb;26(2):207–210. [PubMed] [Google Scholar]
  7. Sierra D. H., Nissen A. J., Welch J. The use of fibrin glue in intracranial procedures: preliminary results. Laryngoscope. 1990 Apr;100(4):360–363. doi: 10.1288/00005537-199004000-00006. [DOI] [PubMed] [Google Scholar]
  8. Staindl O. Tissue adhesion with highly concentrated human fibrinogen in otolaryngology. Ann Otol Rhinol Laryngol. 1979 May-Jun;88(3 Pt 1):413–418. doi: 10.1177/000348947908800320. [DOI] [PubMed] [Google Scholar]
  9. Zumpano B. J., Jacobs L. R., Hall J. B., Margolis G., Sachs E., Jr Bioadhesive and histotoxic properties of ethyl-2-cyanoacrylate. Surg Neurol. 1982 Dec;18(6):452–457. doi: 10.1016/0090-3019(82)90186-0. [DOI] [PubMed] [Google Scholar]

Articles from Skull base surgery are provided here courtesy of Thieme Medical Publishers

RESOURCES