The Use of Fibrin Sealant in the Neurosurgical Treatment of Lesions of the Base of the Skull

Waldbaur, H.; Fahlbusch, R.

doi:10.1007/978-3-642-71391-0_25

Cited by 5 publications

(2 citation statements)

References 2 publications

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“…1.8%, following sealing with fibrin glue together with a collagen fleece. Waldbauer et al 21 report a reoperation for CSF fistula in 1% in comparison to 4%, prior to the introduction of fibrin sealant.…”

Section: Discussionmentioning

confidence: 97%

Fibrin tissue adhesive sealant for the prevention of CSF leakage following transsphenoidal microsurgery

1991

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Fibrin glue (Beriplast, Behring or Tissucol, Immuno) was used for 126 sublabial transseptal transsphenoidal operations in 119 patients from April 1981 to March 1987 in a variety of sellar pathologies together with septal bone and spongycel to seal the sellar floor and the anterior wall of the sphenoid sinus. The incidence of postoperative rhinorrhea was 1.6%. A review of the literature revealed an incidence of 1.5%-9.6% with the use of autologous tissue for sellar packing such as fat or muscle; fibrin glue combined with autologous grafts led to postoperative rhinorrhea in 1%-4.4%. The present results support the view that sellar and sphenoidal sealing with fibrin glue instead of muscle or fat tissue does not raise the incidence of postoperative rhinorrhea.

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Section: Discussionmentioning

confidence: 97%

Fibrin tissue adhesive sealant for the prevention of CSF leakage following transsphenoidal microsurgery

1991

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“…In the 64 patients who developed intraoperative CSF leak, a fibrin glue (Beriplast) was used to fill the intrasellar space, and only 1 of these patients suffered from a postoperative CSF leak. Although these were single‐cohort studies, their rates of postoperative CSF leak were similar to prior studies utilizing autologous tissue for sellar reconstruction (1.5‐9.6%) …”

Section: Intraoperative Considerationsmentioning

confidence: 99%

ICAR: endoscopic skull‐base surgery

Wang

Zanation

Gardner

et al. 2019

Int Forum Allergy Rhinol

157

279

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Background Endoscopic skull‐base surgery (ESBS) is employed in the management of diverse skull‐base pathologies. Paralleling the increased utilization of ESBS, the literature in this field has expanded rapidly. However, the rarity of these diseases, the inherent challenges of surgical studies, and the continued learning curve in ESBS have resulted in significant variability in the quality of the literature. To consolidate and critically appraise the available literature, experts in skull‐base surgery have produced the International Consensus Statement on Endoscopic Skull‐Base Surgery (ICAR:ESBS). Methods Using previously described methodology, topics spanning the breadth of ESBS were identified and assigned a literature review, evidence‐based review or evidence‐based review with recommendations format. Subsequently, each topic was written and then reviewed by skull‐base surgeons in both neurosurgery and otolaryngology. Following this iterative review process, the ICAR:ESBS document was synthesized and reviewed by all authors for consensus. Results The ICAR:ESBS document addresses the role of ESBS in primary cerebrospinal fluid (CSF) rhinorrhea, intradural tumors, benign skull‐base and orbital pathology, sinonasal malignancies, and clival lesions. Additionally, specific challenges in ESBS including endoscopic reconstruction and complication management were evaluated. Conclusion A critical review of the literature in ESBS demonstrates at least the equivalency of ESBS with alternative approaches in pathologies such as CSF rhinorrhea and pituitary adenoma as well as improved reconstructive techniques in reducing CSF leaks. Evidence‐based recommendations are limited in other pathologies and these significant knowledge gaps call upon the skull‐base community to embrace these opportunities and collaboratively address these shortcomings.

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Craniofacial resection for anterior skull base tumours

et al. 1991

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This study presents a series of 10 patients with anterior skull base tumours, treated by a team of neurosurgeons and head- and neck surgeons. The series included 7 malignant tumours of the nose and paranasal sinuses and 1 retinoblastoma, all with intracranial extension through the lamina cribrosa. There were also 2 patients with an anterior base meningioma, growing into the ethmoid sinus and the nasal cavity. 8 tumours were resected by a combined bifrontal craniotomy and uni- or bilateral rhinotomy. In 2 cases a bifrontal craniotomy alone without facial incision sufficed. The skull base was closed with a pediculated pericranial flap and a split-thickness free skin graft underneath. There were no postoperative problems of wound infection, CSF-leakage or meningitis. Recurrent tumour growth or systemic metastasis occurred in 5 out of 7 patients with malignant tumours, 6 months to 2 years postoperatively. The related literature and especially questions of operative indications and technique, including different possibilities of closure and reconstruction of the skull base, are discussed.

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The Use of Fibrin Sealant in the Neurosurgical Treatment of Lesions of the Base of the Skull

Cited by 5 publications

References 2 publications

Fibrin tissue adhesive sealant for the prevention of CSF leakage following transsphenoidal microsurgery

Fibrin tissue adhesive sealant for the prevention of CSF leakage following transsphenoidal microsurgery

ICAR: endoscopic skull‐base surgery

Craniofacial resection for anterior skull base tumours

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