Effective Repair of Dural Tear Using Bioabsorbable Sheet With Fibrin Glue

Iwata, Akio; Takahata, Masahiko; Kadoya, Ken; Sudo, Hideaki; Kokabu, Terufumi; Yamada, Kei; Iwasaki, Norimasa

doi:10.1097/brs.0000000000002095

Cited by 10 publications

(4 citation statements)

References 30 publications

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“…2c). One can also use fibrin glue to prevent leakage from the pinhole [42]. Filling the cranial cavity with warm water is necessary to evacuate the air before complete closure.…”

Section: Discussionmentioning

confidence: 99%

Postoperative Complications of Microscopic Fenestration for Middle Fossa Arachnoid Cysts: A Retrospective Study of 38 Cases and Literature Review

Zheng

Han

et al. 2022

Pediatr Neurosurg

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Introduction: Middle fossa arachnoid cyst (MFAC) is one of the most common cranial cysts in children, and the various postoperative complications following cyst fenestration represent a major concern. We conducted a retrospective study in our department and performed a systematic review of the literature to identify the risk factors for complications. Methods: A retrospective survey was conducted on 38 patients with MFAC (< 14 years) who underwent microscopic fenestration from January 2019 to December 2020. Postoperative complications, including postoperative hemorrhage/hematoma, subdural hygroma (SH), cranial nerve palsy, central nervous system infection (PCNSI), and cerebrospinal fluid (CSF) leak, were collected. A systematic PubMed search for cohort studies on surgically treated MFAC published after 1980 was performed. The postoperative complications in the included studies were illustrated. Results: The overall complication rate in our series was 7.9%, among whom, nine patients (23.7%) developed postoperative SH, one of which required cyst-peritoneal shunting. Patients who developed SH were significantly younger (4.0 ± 1.8 vs 6.3 ± 3.4 years, p = 0.012). Binary logistic analysis showed that a lower age could be a risk factor for developing SH (odds ratio: 0.738, p = 0.067). One patient developed a subdural hematoma. No cranial nerve palsy or CSF leak was observed. Eighteen studies were included in the systematic review, comprising 649 cases of MFAC. The most common complication was SH (4.9%), and the postoperative complication rates were similar between the microscopic and endoscopic techniques. Conclusion: The complication rate of MFAC fenestration is considerable. SH is the most common postoperative complication, and it mostly occurs in young children. Strict surgical indications should be applied for young children.

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“…2c). One can also use fibrin glue to prevent leakage from the pinhole [42]. Filling the cranial cavity with warm water is necessary to evacuate the air before complete closure.…”

Section: Discussionmentioning

confidence: 99%

Postoperative Complications of Microscopic Fenestration for Middle Fossa Arachnoid Cysts: A Retrospective Study of 38 Cases and Literature Review

Zheng

Han

et al. 2022

Pediatr Neurosurg

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“…They contain human plasma protein and thus are immunocompatible and provide the best results. [ 5 6 7 8 ]…”

Section: Discussionmentioning

confidence: 99%

“…[ 4 5 6 ] Of this, the use of fibrin sealants is the latest and such sealants are used for tissue sealing across a range of surgical procedures, including cardiothoracic, gastrointestinal, neurosurgery, and vascular surgeries. [ 7 8 ]…”

Section: Introductionmentioning

confidence: 99%

Management of large dural defect with CSF leak in hypertelorism correction

Balaji¹,

Ganesh²,

Balaji³

2021

Ann Maxillofac Surg

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The Rationale: Dural tear is a serious complication during hypertelorism corrective surgeries. Identifying the tear and managing requires considerable expertise. Managing large dural tears correctly is necessary to prevent cerebrospinal fluid (CSF)-related complications in craniofacial surgery. Patient Concerns: The patient presented with hypertelorism as a part of the Tessier Cleft 0 and sought to correct the widely placed eyes. Diagnosis: Large critical-sized dural tear during modified box osteotomy surgery. Treatment: Besides successful modified box osteotomy surgery, the critical-sized dural tear was managed with fascia lata and fibrin glue. Outcomes: There was no CSF leak or related complication postsurgically indicating successful sealing and healing of the dural tear. Take-Away Lessons: The synergistic mechanism by which fascia lata graft and fibrin glue help to hermetically seal the critical-sized defect, especially when there are variable amounts of hydrostatic-hydrodynamic forces of CSF exerting pressure on the patched area, is discussed.

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“…Since the dura is a non-regenerative tissue [ 8 ], repair techniques or materials that can quickly seal leaks and promote the formation of surrounding fibrous connective tissue to close the dural defect are urgently needed. So far, many techniques and materials have been reported to repair spinal dural defect, including simple sutures, sealants, bioabsorbable staples, and various types of grafts and patches [ [9] , [10] , [11] , [12] , [13] , [14] ]. Among these repair methods, sutures will lead to needle holes leakage, and sealants can not meet the demand of dural defect repair because of its poor sealing effect in large spinal dural defect [ 15 ].…”

Section: Introductionmentioning

confidence: 99%