J Neurol Surg B
DOI: 10.1055/s-0039-1694048
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Adherus Dural Sealant in Endoscopic Skull Base Surgery: Safety, Imaging Characteristics, and Sinonasal Quality of Life

1  Departments of Otolaryngology–Head and Neck Surgery, Weill Cornell Medicine, New York Presbyterian Hospital, New York, New York, United States
,
Charles A. Riley
1  Departments of Otolaryngology–Head and Neck Surgery, Weill Cornell Medicine, New York Presbyterian Hospital, New York, New York, United States
,
Shlomo Minkowitz
2  Departments of Radiology, Weill Cornell Medicine, New York Presbyterian Hospital, New York, New York, United States
,
Abtin Tabaee
1  Departments of Otolaryngology–Head and Neck Surgery, Weill Cornell Medicine, New York Presbyterian Hospital, New York, New York, United States
,
Vijay K. Anand
1  Departments of Otolaryngology–Head and Neck Surgery, Weill Cornell Medicine, New York Presbyterian Hospital, New York, New York, United States
,
Theodore H. Schwartz
3  Departments of Neurosurgery, Weill Cornell Medicine, New York Presbyterian Hospital, New York, New York, United States
› Author Affiliations
Further Information

Publication History

07 February 2019

11 June 2019

Publication Date:
02 August 2019 (online)

Abstract

Objective This study was aimed to compare the safety profiles, magnetic resonance imaging (MRI) findings, and sinonasal outcome test (SNOT-22) scores of Adherus dural sealant, a novel tissue glue designed for skull base surgery.

Design Present study is a prospective case series.

Setting The research work took place at a tertiary-care academic medical center.

Participants Consecutive series of 26 patients undergoing endoscopic skull base surgery (ESBS) with Adherus was compared with a control group of 24 patients matched for tumor type and size with DuraSeal as a sealant.

Main Outcome Measures Postoperative complication rates, imaging characteristics, and postoperative SNOT-22 scores were measured and compared.

Results No postoperative cerebrospinal fluid (CSF) leaks, intracranial hemorrhages, or mucoceles were observed in either cohort. Adherus was more likely to be identifiable on immediate postoperative MRI (50 vs. 20.8%, p = 0.032). In patients in whom a nasoseptal flap was utilized, the flap was opposed to the skull base in all cases regardless of sealant selected. Postoperative SNOT-22 total (17.25 [±10.81] vs. 14.85 [±14.22], p = 0.609) and subdomain scores were similar between the two groups.

Conclusions Adherus dural sealant appears to be a safe alternative to Duraseal in ESBS with comparable quality of life outcomes and imaging findings. These preliminary results are promising but should be examined in a larger population with long-term follow-up.

Note

Presented at the American Academy of Otolaryngology–Head and Neck Surgery Annual Meeting, October 2018, Atlanta, Georgia, United States.