Fibrin glue as an adjuvant dural sealant reduces the rate of perioperative complications in posterior fossa decompression with duraplasty: A single center experience in 165 adult Chiari I patients

Galán, Diego; Monuszko, Karen; Sankey, Eric W.; Zakare-Fagbamila, Rasheedat; Yang, Zidanyue; Niedzwiecki, Donna; Gottfried, Oren N.; Bagley, Carlos A.; Krucoff, Max O.

doi:10.1016/j.jocn.2019.07.036

Cited by 5 publications

(13 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We believe that using the exclusion method is the simplest and most effective approach, but the possibility of secondary headache due to other etiologies should also be ruled out when the typical headache is excluded, as suggested by Galan et al. (31).…”

Section: Surgery For Typical Headachementioning

confidence: 94%

“…Krucoff et al (29) directly employed the diagnostic criteria of primary headaches to identify atypical headaches of CIMs. Meanwhile, some use the exclusion method that divided all headaches that did not fulfill the criteria for typical headaches were defined as by Beretta et al ( 9) and Galan et al (31). We believe that using the exclusion method is the simplest and most effective approach, but the possibility of secondary headache due to other etiologies should also be ruled out when the typical headache is excluded, as suggested by Galan et al (31).…”

Section: Atypical Headaches Of Cimmentioning

confidence: 99%

“…The definition of a typical headache of CIM. Before CIM typical headache was formally defined, the typical headache attributed to CIM was regarded as occipital cough headache (3,9,20,(28)(29)(30)(31). However, identifying it in clinical practice can be challenging given its significant heterogeneity.…”

Section: The Typical Headache Of Cimmentioning

confidence: 99%

See 2 more Smart Citations

Prevalence and treatment of typical and atypical headaches in patients with Chiari I malformation: A meta-analysis and literature review

Zhang

Huang

et al. 2023

Cephalalgia

View full text Add to dashboard Cite

Objective A meta-analysis was conducted to analyze the incidence of typical and atypical headaches and outcomes following various treatments in patients with Chiari I malformation. Background Headache is the most common symptom of Chiari malformation, which can be divided into typical and atypical subgroups to facilitate management. Much controversy surrounds the etiology, prevalence and optimal therapeutic approach for both types of headaches. Method We identified relevant studies published before 30 July 2022, with an electronic search of numerous literature databases. The results of this study were reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Result A total of 1913 Chiari malformation type I CIM patients were identified, 78% of whom presented with headache, within this group cephalgia was typical in 48% and atypical in 29% of patients, and migraine was the most common type of atypical headache. The ratio of typical/atypical headaches with international classification of headache disorders diagnosis was 1.53, and without international classification of headache disorders diagnosis was 1.56, respectively. The pooled improvement rates of typical headaches following conservative treatment, extradural decompression and intradural decompression were 69%, 88%, and 92%, respectively. The corresponding improvement rates for atypical headaches were 70%, 57.47%, and 69%, respectively. The complication rate in extradural decompression group was significantly lower than in intradural decompression group (RR, 0.31; 95% CI: 0.06–1.59, I2 = 50%, P = 0.14). Low reoperation rates were observed for refractory headaches in extradural decompression and intradural decompression groups (1%). Conclusion The International Classification of Headache Disorders can assist in screening atypical headaches. extradural decompression is preferred for typical headaches, while conservative therapy is optimal for atypical headaches. A definite correlation exists between atypical headaches and Chiari Malformation Type I patients with higher prevalence than in the general population. Importantly, decompression is effective in relieving headaches in this particular patient population.

show abstract

Section: Surgery For Typical Headachementioning

confidence: 94%

Section: Atypical Headaches Of Cimmentioning

confidence: 99%

See 1 more Smart Citation

Prevalence and treatment of typical and atypical headaches in patients with Chiari I malformation: A meta-analysis and literature review

Zhang

Huang

et al. 2023

Cephalalgia

View full text Add to dashboard Cite

show abstract

“…26 In a retrospective review of 165 adult patients who underwent PFDD for CMI with an allograft or xenograft, as well as Tisseel or DuraSeal, the authors observed higher rates of pseudomeningocele, CSF leaks, and wound infection in the DuraSeal group at 23.1%, 19.2%, and 15.4%, respectively, but their results did not reach statistical significance. 22 Du-raSeal was used in only 26 patients in their cohort, so their study may have been underpowered. In our study, DuraSeal was used in a greater number of patients, and this increased the power to uncover associations between complications and sealant use.…”

Section: Effect Of Dural Sealantsmentioning

confidence: 99%

Association between synthetic sealants and increased complication rates in posterior fossa decompression with duraplasty for Chiari malformations regardless of graft type

Makoshi

Toop

Smith

et al. 2022

Journal of Neurosurgery: Pediatrics

View full text Add to dashboard Cite

OBJECTIVE Dural sealants are commonly used in posterior fossa decompression with duraplasty (PFDD) for Chiari malformation type I (CMI). Prior evidence suggests that combining certain sealants with some graft material is associated with an increased rate of complications. In 2018, the authors noted an increased rate of symptomatic pseudomeningocele and aseptic meningitis after PFDD in CMI patients. The authors utilized retrospective and prospective analyses to test the hypothesis that complication rates increase with the use or combination of certain sealants and grafts. METHODS The analysis was split into 2 periods. The authors retrospectively reviewed patients who underwent PFDD for CMI at their center between August 12, 2011, and December 31, 2018. The authors then eliminated use of DuraSeal on the basis of the retrospective analysis and prospectively examined complication rates from January 1, 2019, to August 4, 2021. The authors defined a complication as symptomatic pseudomeningocele, bacterial or aseptic meningitis, cerebrospinal fluid leak, subdural hygroma, hydrocephalus, surgical site infection, or wound dehiscence. RESULTS From 2011 to 2018, complications occurred in 24.5% of 110 patients. Sealant choice was correlated with complication rates: no sealant (0%), Tisseel (6%), and DuraSeal (15.3%) (p < 0.001). No difference in complication rate was noted on the basis of choice of graft material (p = 0.844). After eliminating DuraSeal, the authors followed 40 patients who underwent PFDD after 2018. The complication rate decreased to 12.5%. All complications after 2018 were associated with Tisseel. CONCLUSIONS At the authors’ single center, use of sealants in PFDD surgery for CMI, especially DuraSeal, was correlated with a higher complication rate. Eliminating DuraSeal led to a significant decrease in the rate of symptomatic pseudomeningocele and aseptic meningitis.

show abstract

“…4 Tisseel does not adversely affect healing when applied to the anastomosis region of anastomosed flaps. 5 Tisseel has been used to seal wounds in various surgical applications, including dural repair, 6 and to maintain grafts placed into the frontal sinuses for obliteration after trauma. 7 To retain a graft in position, Tisseel used in a calvarial defect study resulted in more bone formation compared with defects grafted with material without Tisseel.…”

mentioning

confidence: 99%

Use of Tisseel, a Fibrin Sealant, for Particulate Graft Stabilization

Block

Zoccolillo

2020

Journal of Oral and Maxillofacial Surgery

View full text Add to dashboard Cite

Fibrin glue as an adjuvant dural sealant reduces the rate of perioperative complications in posterior fossa decompression with duraplasty: A single center experience in 165 adult Chiari I patients

Cited by 5 publications

References 32 publications

Prevalence and treatment of typical and atypical headaches in patients with Chiari I malformation: A meta-analysis and literature review

Prevalence and treatment of typical and atypical headaches in patients with Chiari I malformation: A meta-analysis and literature review

Association between synthetic sealants and increased complication rates in posterior fossa decompression with duraplasty for Chiari malformations regardless of graft type

Use of Tisseel, a Fibrin Sealant, for Particulate Graft Stabilization

Contact Info

Product

Resources

About