SKULL BASE CEREBROSPINAL-FLUID LEAKAGE CONTROL WITH A FIBRIN-BASED COMPOSITE TISSUE ADHESIVE

Cerebrospinal fluid (CSF) leaks can be responsible for significant pat ient morbidity and mortality. While the majority of leaks induced afte r head trauma will seal without intervention, spontaneous of surgicall y-induced leaks often require operative repair. Many modifications on standard surgical technique are available for repair of CSF fistulae, but none assures adequate closure. We have studied the efficacy of a n ovel fibrin-based composite tissue adhesive (CTA) for closure of exper imentally-induced CSF leaks in rats. Fistulae were created in two grou ps of animals. Two weeks after creation of the leaks, the animals were sacrificed and analyzed for persistence of leak. A 58% leakage rate w as noted in the control group (n = 12), and no leaks were noted in the experimental group closed application of CTA to the surgical defect f ollowed by skin closure (n = 11). Comparing the control group to the e xperimental group, results were statistically significant (p = 0.015). These data suggest that CTA may be effective as a adjunct for the clo sure of CSF fistulae.