title: Vivostat®: an autologous fibrin sealant as useful adjunct in endoscopic transnasal CSF-leak repair.
abstract: The benefit of fibrin glue for reduction of postoperative CSF-leaks after endoscopic skull base surgery is not clearly evident in literature. However, its use is supposed to be beneficial in fixing grafting material. As of today there is no specific data available for otolaryngological procedures. A retrospective data analysis at a tertiary care referral center on 73 patients treated endoscopically transnasally for CSF-leaks at the ENT-department Graz between 2009 and 2012 was performed. Primary closure rate between conventional fibrin glue and autologous fibrin glue were analyzed. The Vivostat(®) system was used in 33 CSF-leak closures and in 40 cases conventional fibrin glue was used. Comparing the two methods the primary closure rate using the autologous Vivostat(®) system was 75.8 and 85.0 % with conventional fibrin glue. The secondary closure the rates were 90.9 % with Vivostat(®) 92.5 % with conventional fibrin glue. The Vivosat(®) system is a useful adjunct in endoscopic CSF-leak closure. Its advantages over conventional fibrin glue are its application system for fixation of grafting material particularly in underlay techniques. Despite this advantage it cannot replace grafting material or is a substitute for proper endoscopic closure which is reflected by the closure rates.
authors.affiliation: Department of General Otorhinolaryngology, Head and Neck Surgery, ENT-University Hospital Graz, Medical University Graz, Auenbruggerplatz 26/28, 8036, Graz, Austria, peter.tomazic@medunigraz.at.
authors.forename: Peter Valentin
authors.initials: PV
authors.lastname: Tomazic
authors.forename: Stefan
authors.initials: S
authors.lastname: Edlinger
authors.forename: Verena
authors.initials: V
authors.lastname: Gellner
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Koele
authors.forename: Claus
authors.initials: C
authors.lastname: Gerstenberger
authors.forename: Hannes
authors.initials: H
authors.lastname: Braun
authors.forename: Michael
authors.initials: M
authors.lastname: Mokry
authors.forename: Heinz
authors.initials: H
authors.lastname: Stammberger
mesh_terms: D002559:Cerebrospinal Fluid Rhinorrhea / Q000209:etiology / Q000628:therapy; D057186:Comparative Effectiveness Research; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D057605:Natural Orifice Endoscopic Surgery / Q000009:adverse effects / Q000379:methods; D011183:Postoperative Complications / Q000628:therapy*; D012189:Retrospective Studies; D019291:Skull Base / Q000601:surgery; D014014:Tissue Adhesives / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives
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