TITLE

Testing Biomechanical Strength of In Vitro Cerebrospinal Fluid Leak Repairs

AUTHOR(S)
de Almeida, John R.; Morris, Alan; Whyne, Cari M.; James, Adrian L.; Witterick, Ian J.
PUB. DATE
February 2009
SOURCE
Journal of Otolaryngology -- Head & Neck Surgery;Feb2009, Vol. 38 Issue 1, p106
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Objectives: Repair of cerebrospinal fluid (CSF) leaks with grafts can be augmented with various adjuncts to improve approximation such as tissue adhesives and sutures. Here we test various adjuncts in an in vitro model of CSF leak repairs. Methods: A novel pressure testing system was designed to evaluate the burst pressures of in vitro CSF leak repairs. Porcine pericranium grafts were harvested and used to repair a 0.5 X 0.5 cm dural defect. These grafts were sealed in place with no adjunct (control). Tisseel fibrin glue (Baxter, Mississauga, ON), suture, U-CLIPs (a self-closing suture substitute; Medtronic, Toronto, ON), or combined suture and Tisseel. Tisseel samples were tested both as underlay and overlay repairs. Samples were incubated overnight in serum and subjected to burst pressure testing, and pressure-time graphs were recorded. Experiments were conducted five times. Results: Mean burst pressures (measured in pounds per square inch) for grafts sealed in place with Tisseel were significantly higher than all other adjuncts (14.9 Tisseel vs 3.9 control vs 4.1 U-CUP vs 6.2 suture psi; p < .05). U-CLIPs and sutures did not increase burst strength over controls, and sutures did not have a synergistic effect with Tisseel (12.1 psi). Grafts tested with Tisseel were stronger when tested as underlay than as overlay (14.9 vs 3.0 psi). Three patterns of graft failure were observed based on unique pressure-time graphs. Conclusions: In vitro burst pressure testing demonstrates that Tisseel improves the strength of CSF leak repairs.
ACCESSION #
43205844

 

Related Articles

  • 'Intracranial shunts 101' for the opthalmologist. Lee, Andrew G. // Ophthalmology Times;6/1/2004, Vol. 29 Issue 11, p56 

    Discusses considerations for ophthalmologists in the use of intracranial shunt to decrease intracranial pressure in hydrocephalus or in pseudotumor cerebri. Components of a typical shunt; Description of shunt malfunction, shunt failure, shunt infection, signs of failure and diagnostic...

  • Quantitative analysis of continuous intracranial pressure recordings in symptomatic patients with extracranial shunts. Elde, P. K. // Journal of Neurology, Neurosurgery & Psychiatry;Feb2003, Vol. 74 Issue 2, p231 

    Objectives: To explore the outcome of management of possible shunt related symptoms using intracranial pressure (ICP) monitoring, and to identify potential methodological limitations with the current strategies of ICP assessment. Methods: The distribution of persistent symptoms related to...

  • Unusual cause of breast lump: a CSF pseudocyst. Jakhere, Sandeep Gopal; Kumbhar, Raju; Dhongade, Harshal // South African Journal of Radiology;Jun2012, Vol. 16 Issue 2, p69 

    A ventriculoperitoneal (VP) shunt is a fairly common and useful procedure to reduce intracranial pressure in patients with hydrocephalus. Complications associated with VP shunts are usually related to either shunt obstruction or infection. A pseudocyst formation owing to leakage of CSF into the...

  • Reply to Failure of combined costimulatory blockade in animal transplant model. Li, Yongsheng; Strom, Terry B. // Nature Medicine;Feb2000, Vol. 6 Issue 2, p115 

    Replies to a comment on the authors' paper 'Failure of combined costimulatory blockade in animal transplant model.' Point about the ability of costimulation blockade using anti-CD154 and CTLA4-Ig to produce permanent engraftment in allograft models.

  • Data confirm protective effect of MMF on long-term graft survival.  // Kidney;Jan/Feb2001, Vol. 10 Issue 1, p33 

    Presents an abstract of the study 'Mycophenolate Mofetil Reduces Late Renal Allograft Loss Independent of Acute Rejection,' by A.O. Ojo, H.-U. Meier-Kriesche, J.A. Hanson et al.

  • Sirolimus with CSA/prednisone decreases acute rejection.  // Kidney;Jan/Feb2001, Vol. 10 Issue 1, p41 

    Presents an abstract of the study 'Efficacy of Sirolimus Compared With Azathioprine for Reduction of Acute Renal Allograft Rejection: A Randomised Multicentre Study,' by B.D. Kahan.

  • Leucocytosis is not a manifestation of rejection. Daar, A.S.; Morris, P.J.; Oliver, D.O. // British Medical Journal;12/17/1977, Vol. 2 Issue 6102, p1570 

    Analyzes the leucocyte response to allograft rejection in Great Britain. Responsibility of leucocytes and platelets in mediating graft damage; Effect of large doses of steroids; Role of rejection process on the leucocyte count decrease.

  • Imminent allograft rejection prevented by donor lymphocyte transfusions: report of two pediatric cases. Saarinen-Pihkala, U M; Taskinen, M; Vettenranta, K; Hovi, L // Bone Marrow Transplantation;May2003, Vol. 31 Issue 9, p833 

    Summary:Gradual allograft rejection after initial good engraftment may occur with simultaneous autologous reconstitution particularly in patients receiving nonmyeloablative conditioning. Careful post-transplant follow-up of the chime rism status can reveal these cases early on, when the...

  • CAROTID ENDARTERECTOMY WITH A NEW SHUNT. Fadhli, Hussam A. // Vascular Surgery;Mar/Apr1974, Vol. 8 Issue 2, p71 

    Presents information on using an internal carotid shunt in carotid endarterectomy. Advantages of using the method on cerebral blood circulation; Considerations for using a shunt on carotid endarterectomies; Factor which eliminates possible forceful removal of the shunt and suture line...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics