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CC BY 4.0 · Int Arch Otorhinolaryngol 2025; 29(02): s00441788599
DOI: 10.1055/s-0044-1788599
Original Research

Regenerated Oxidized Cellulose as a Sealant and Adhesive in Endoscopic Endonasal Skull Base Reconstruction

Autor*innen

  • Ashwin Gajendran Vedhapoodi 

    1   Department of Otorhinolaryngology, Head and Neck Surgery, Government Stanley Medical College, Chennai, Tamil Nadu, India

  • Aravind Sabesan

    2   Department of Neurosurgery, Government Stanley Medical College, Chennai, Tamil Nadu, India

  • Benazir Ferozkhan

    1   Department of Otorhinolaryngology, Head and Neck Surgery, Government Stanley Medical College, Chennai, Tamil Nadu, India

  • Saravana Selvan Velmurugan

    3   Department of Otorhinolaryngology, Madras Medical College, Chennai, Tamil Nadu, India

  • Venkatesan Rajarajan

    1   Department of Otorhinolaryngology, Head and Neck Surgery, Government Stanley Medical College, Chennai, Tamil Nadu, India

  • Baskar Arukavur Radhakrishnan

    2   Department of Neurosurgery, Government Stanley Medical College, Chennai, Tamil Nadu, India

  • Kanagaraman Prabhuraman

    2   Department of Neurosurgery, Government Stanley Medical College, Chennai, Tamil Nadu, India

  • Bhuvaneswari Natarajan

    4   Department of Community Medicine, Sri Venkateswaraa Medical College Hospital and Research Centre, Puducherry, Tamil Nadu, India

Funding The authors did not receive funding from agencies in the public, private, or non-profit sectors for the conduction of the present study.
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Abstract

Introduction An ideal and long-lasting adhesive and sealant is essential during endoscopic endonasal skull-base surgery to hold the reconstruction intact and prevent cerebrospinal fluid (CSF) permeation until complete healing occurs. Fibrin glue is the most common material used. Regenerated oxidized cellulose (ROC) has not been mentioned in the literature as sealant and adhesive, and, hence, we intended to study this role.

Objective To evaluate the role of ROC as tissue sealant and adhesive in the reconstruction of skull-base defects in endoscopic endonasal skull-base surgery.

Methods We retrospectively analyzed the medical records of patients who underwent endoscopic endonasal skull-base surgery with skull-base defect and intraoperative CSF leak, for which reconstruction was performed using fibrin glue or ROC, or both, as a sealant and adhesive. The type of sealant and adhesive used and postoperative CSF leak rates with different agents used were analyzed.

Results A total of 64 patients were investigated. Fibrin glue alone was used initially in 6 patients, of which 4 (66.6%) experienced postoperative CSF leak. Both fibrin glue and ROC were used in 26 patients, among which 2 (7.6%) exhibited postoperative CSF leak. Regenerated oxidized cellulose alone was used in 24 patients, wherein 2 (8.3%) presented with postoperative CSF leak. Fibrin glue alone was once again used later in the learning curve in 8 patients, of which 2 (25%) experienced postoperative CSF leak (p = 0.002).

Conclusion Fibrin glue provides intraoperative watertight seal. Regenerated oxidized cellulose has better intraoperative and long-term sealant and adhesive action in endoscopic endonasal skull-base reconstruction.

Keywords

Surgicel - regenerated oxidized cellulose - CSF leak - tissue sealant - tissue adhesive

Authors' Contribution

Study design: Ashwin Vedhapoodi Gajendran.


Data Collection and analysis: Ashwin Vedhapoodi Gajendran, Aravind Sabesan, Benazir F, Saravana Selvan V, Venkatesan Rajarajan, Baskar A R, and Prabhuraman K.


Statistical analysis: Bhuvaneswari Natarajan, Ashwin Vedhapoodi Gajendran, and Benazir F.


Manuscript preparation: Ashwin Vedhapoodi Gajendran and Benazir F.




Publikationsverlauf

Eingereicht: 10. September 2023

Angenommen: 19. Mai 2024

Artikel online veröffentlicht:
15. April 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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Bibliographical Record
Ashwin Gajendran Vedhapoodi, Aravind Sabesan, Benazir Ferozkhan, Saravana Selvan Velmurugan, Venkatesan Rajarajan, Baskar Arukavur Radhakrishnan, Kanagaraman Prabhuraman, Bhuvaneswari Natarajan. Regenerated Oxidized Cellulose as a Sealant and Adhesive in Endoscopic Endonasal Skull Base Reconstruction. Int Arch Otorhinolaryngol 2025; 29: s00441788599.
DOI: 10.1055/s-0044-1788599