Use of cyanoacrylate to prevent cerebrospinal fluid fistulas after cranial surgery

Abstract

Purpose: Cerebrospinal fluid (CSF) fistula is one of the most common complications encountered after cranial surgeries. In cases where CSF fistula frequently appears due to surgical technique, dural sealants are used as auxiliary preparations to prevent CSF fistula and provide convenience to the surgeon. Materials and Methods: Data obtained from 128 number of cases where cyanoacrylate (CA) had been used for dural repair to prevent CSF fistula was evaluated, retrospectively. The cases of skull base and frontal sinus fractures where the primary repair had not been carried out were also included in the study. Results: The mean follow-up of all cases was 9,7 months. CSF fistula was not encountered in 121 of 128 cases. 4 of the cases developed CSF fistula in the early period. 3 of the cases presented with CSF fistula in the late period after discharge. No side effects due to hypersensitivity or preparation were encountered. Conclusion: CA can help dural repair against the development of CSF fistula by taking effect quickly. Also, it is a rapid anti-haemorrhagic agent. It can also be used after posterior fossa surgery, skull base surgery where dural repair is difficult, or during sinus repair.