Vivostat®: an autologous fibrin sealant as useful adjunct in endoscopic transnasal CSF-leak repair

Eur Arch Otorhinolaryngol. 2015 Jun;272(6):1423-7. doi: 10.1007/s00405-014-3230-0. Epub 2014 Aug 8.

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.

Publication types

  • Comparative Study

MeSH terms

  • Cerebrospinal Fluid Rhinorrhea* / etiology
  • Cerebrospinal Fluid Rhinorrhea* / therapy
  • Comparative Effectiveness Research
  • Female
  • Fibrin Tissue Adhesive / therapeutic use*
  • Humans
  • Male
  • Middle Aged
  • Natural Orifice Endoscopic Surgery / adverse effects
  • Natural Orifice Endoscopic Surgery / methods
  • Postoperative Complications / therapy*
  • Retrospective Studies
  • Skull Base / surgery
  • Tissue Adhesives / therapeutic use
  • Treatment Outcome

Substances

  • Fibrin Tissue Adhesive
  • Tissue Adhesives