Skull Base Csf- Leak Closure with Autologous Fibrin Sealant

Document Type : Original

Authors

1 Otorhinolaryngology Unit, Villa Sofia-Cervello Hospital, Palermo, Italy.

2 Otorhinolaryngology Unit, Department of Bi. N. D., University of Palermo, Palermo, Italy.

3 Otolaryngology Unit, Cannizzaro Hospital, Catania, Italy.

Abstract

Introduction
There are many fibrin-derived sealants used as topical haemostatic agents in many surgical procedures. Fibrin sealants are usually non-autologous derivatives or animal derivatives, with the exception of Vivostat®, an autologous fibrin sealant derived from patients own blood.
 
Materials and Methods
We present our experience on the use of Vivostat® in skull base closures in 20 patients operated at the Otorhinolaryngology Unit of the Hospital Ospedali Riuniti Villa Sofia - Cervello of Palermo. All postoperative patients were placed in an anti-trendeleburg position for 48 hours. After removal of the nasal swabs we did not find any rhinorrhea and we checked the tightness of the skull base defect with computed tomography.
 
Results
On a total of the 20 patients (10 post-traumatic and 10 with iatrogenic leaks), 9 out of 10 post-traumatic cases had a leak in the border area between the anterior and posterior portion of the ethmoid, while 1 patient out of 10 post-traumatic cases had a leak at the level of the sella. In all 20 patients, we repaired skull base defects by fixing grafting materials with Vivostat®. We have not had any complications. Vivostat® is a useful product in skull base repair and safe for the patients.
 
Conclusion
Vivostat® has been used as a sealant on body tissues with greater elasticity and more resistant allowing better and safer wound repair, especially in skull base surgery. In particular, its immediate polymerisation is very useful for an evaluation of the mechanical sealants in the closure of the skull base cerebrospinal fluid leak.

Keywords

References

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Iranian Journal of Otorhinolaryngology
Volume 33, Issue 1
January and February 2021
Pages 3-8

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