Using an autologous fibrin sealant in the preventing of cerebrospinal fluid leak with large skull base defect following endoscopic endonasal transsphenoidal surgery

Yıldırım, Ali Erdem; Dursun, Engin; Özdöl, Çağatay; Divanlıoğlu, Denizhan; Nacar, Osman Arikan; Koyun, Oguz Kara; Ilmaz, Adil Ery; Belen, Ahmet Deniz

doi:10.5137/1019-5149.jtn.7750-12.0

Cited by 11 publications

(7 citation statements)

References 20 publications

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“…It is also useful for various types of pathologies such as congenital lesions, hematomas evacuation, tumor excisions, and infective pathologies. [11][12][13] Endoscopic techniques for TN were found to be safe in our study; other authors made similar observations. The endoscopic procedure was very effective with good outcome rate in our study, as other authors have also observed.…”

Section: Discussionsupporting

confidence: 86%

Comparative evaluation of microscopic vascular decompression and endoscopic vascular decompression for trigeminal neuralgia: A clinical study

Khanuja¹,

Shekhawat²,

Sinha³

et al. 2020

IJN

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Aim: was to compare and evaluate microscopic vascular decompression and endoscopic vascular decompression for trigeminal neuralgia. Setting and Design: It is an observational study Materials and Methods: The present study was conducted in Department of Neurosurgery at SMS Medical College during November 2017-December 2019 among the patients with the diagnosis of medically refractory trigeminal neuralgia. Thirty three patients were recruited for the study, out of which 22 and 11 underwent MVD and EMVD respectively. Before the surgery parameters like age, gender, chief complaints, duration of symptom, side and number of involved branches were recorded. Patients with trigeminal neuralgia were managed by surgical exploration using a standard retrosigmoid approach. Patients were followed up at one and three months post-surgery. Outcomes were categorized into four groups: excellent, good, fair, and poor. Various complications and relive of symptoms were also recorded. Statistics: Difference between two groups was determined using chi square test and the level of significance was set at p < 0.05. Results: Excellent outcome was reported among 81.82% of the subjects in EMVD while it was found only in 59.09% of the subjects in MVD group. Poor outcome was revealed only in 4.55% of the subjects in MVD group with statistically insignificant difference. Conclusion: It can be concluded from the results of present study that endoscopic microvascular decompression is a safe, feasible and effective procedure for cure of trigeminal neuralgia.

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Section: Discussionsupporting

confidence: 86%

Comparative evaluation of microscopic vascular decompression and endoscopic vascular decompression for trigeminal neuralgia: A clinical study

Khanuja¹,

Shekhawat²,

Sinha³

et al. 2020

IJN

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“…It is a relatively common (up to 30% in posterior fossa surgeries) but potentially avoidable complication (3,10,22). Therefore, preventing CSF leak with watertight closure of dura mater is critical step of neurosurgical operations (15,24,25). Even though there have been several studies exploring various agents and techniques, the quest for the ideal dural sealing technique continues.…”

Section: Discussionmentioning

confidence: 99%

Identification of risk factors for postoperative cerebrospinal fluid leakage and comparison of two alternative dural augmentation techniques in posterior fossa and spinal surgeries

Eser¹,

Hanalıoğlu²,

Cetiner³

et al. 2018

Turkish Neurosurgery

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may increase the risk of meningitis, compromise wound healing and cause disturbances of CSF dynamics (1,4). These potential complications, in turn, lead to increased morbidity, prolonged hospital stay, repeated surgical interventions, higher economical costs and frustration to both patients and health professionals (5,9,10,12). █ INTRODUCTION A chieving watertight closure of dura mater is critical in most neurosurgical procedures as cerebrospinal fluid (CSF) leakage is a common and potentially harmful complication. Failure to prevent CSF leaks after dural closure AIM: To investigate comparative efficacy of a novel absorbable adhesive membrane (TissuePatchDural TM "TPD") and a fibrin glue (Tisseel "T") in reducing cerebrospinal fluid (CSF) leaks after posterior fossa and spinal procedures, and also to identify potential risk factors for CSF leakage. MATERIAL and METHODS: This is a single-center, retrospective cohort study of 123 consecutive posterior fossa (n=77) and spinal (n=46) surgeries. Patients were grouped based on dural sealants used 2-group comparison: TPD (n=56) vs. no-TPD (n=67) and 3-group comparison: T only (n=43), TPD only (n=32) vs TPD+T (n=35). RESULTS: Mean age was 38.9 ± 22.2 years (62 males, 61 females). Baseline characteristics were similar between groups. Neither 2-group (TPD: 10.4% vs no-TPD: 8.9%; p=0.778) nor 3-group (T: 9.3% vs TPD: 6.3% vs TPD+T: 14.3%; p=0.539) comparisons revealed a significant difference in postoperative CSF leakage rates. Multivariate analysis showed that diagnosis (non-tumoral vs. tumor) (OR: 5.487; 95% CI: 1.118-26.937; p=0.036); previous surgery (OR: 9.268; 95% CI: 1.911-44.958; p=0.006), postoperative hydrocephalus (OR: 5.456; 95% CI: 1.250-23.821; p=0.024) were independent predictors of postoperative CSF leakage. CONCLUSION: TissuePatchDural TM is a novel dural sealant patch which can be safely used to reinforce dural closure in posterior fossa and spinal surgeries, and its efficacy is comparable to widely used fibrin glue (Tisseel). Non-tumoral pathologies, previous surgery, and postoperative hydrocephalus appear to be independent risk factors for postoperative CSF leakage.

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“…Most of the fibrin‐based sealants (Beriplast, Tisseel, Tissucol, Tachosil, and Bolheal) are made from pooled donor human plasma with additional equine collagen (Tachosil), whereas Bioglue contains bovine proteins, incurring the risk exist of transmitting various blood‐borne viruses, prion disease, or allergic reaction to the foreign proteins. These risks are minimized if autologous blood is utilized, such as with Vivostat (Vivostat A/S, Alleroed, Denmark) . Additionally, the use of tissue sealants does increase surgical costs .…”

Section: Intraoperative Considerationsmentioning

confidence: 99%

ICAR: endoscopic skull‐base surgery

Wang

Zanation

Gardner

et al. 2019

Int Forum Allergy Rhinol

160

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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Using an autologous fibrin sealant in the preventing of cerebrospinal fluid leak with large skull base defect following endoscopic endonasal transsphenoidal surgery

Cited by 11 publications

References 20 publications

Comparative evaluation of microscopic vascular decompression and endoscopic vascular decompression for trigeminal neuralgia: A clinical study

Comparative evaluation of microscopic vascular decompression and endoscopic vascular decompression for trigeminal neuralgia: A clinical study

Identification of risk factors for postoperative cerebrospinal fluid leakage and comparison of two alternative dural augmentation techniques in posterior fossa and spinal surgeries

ICAR: endoscopic skull‐base surgery

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