a purely synthetic & absorbable material · a purely synthetic & absorbable material for...
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![Page 1: A Purely Synthetic & Absorbable Material · A Purely Synthetic & Absorbable Material for CSF Rhinorrhoea repair P Modayil, S Little, A Toma St. George’s Hospital BRS meeting 2013](https://reader036.vdocuments.mx/reader036/viewer/2022062602/5edf218aad6a402d666a7b1c/html5/thumbnails/1.jpg)
A Purely Synthetic & Absorbable Material
for
CSF Rhinorrhoea repair
P Modayil, S Little, A Toma
St. George’s Hospital
BRS meeting 2013
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CSF Rhinorrhoea
Definition
Causes
Risk
Surgical approaches: Intracranial
Tran-nasal (preferred)
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Materials used
Fat plug, Fascia lata, Temporalis fascia
Free / pedicled mucosal grafts
Semi-synthetic
Synthetic
BRS meeting 2013
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Materials used
Fat plug, Fascia lata, Temporalis fascia
Free / pedicled mucosal grafts
Semi-synthetic
Synthetic
BRS meeting 2013
![Page 5: A Purely Synthetic & Absorbable Material · A Purely Synthetic & Absorbable Material for CSF Rhinorrhoea repair P Modayil, S Little, A Toma St. George’s Hospital BRS meeting 2013](https://reader036.vdocuments.mx/reader036/viewer/2022062602/5edf218aad6a402d666a7b1c/html5/thumbnails/5.jpg)
TissuePatch Dural (OBEX)
Polylactide-co-
glycolide (PLGA)
Ready to use multi-
laminate film with an
adhesive surface
Clings, bonds, and
seals within 30
seconds
Absorbed in 50 days BRS meeting 2013
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Case Series
4 cases of CSF Rhinorrhoea- All β2 Transferrin positive
Cases Etiology Site of leak Size of leak Radiology
1 Traumatic Sphenoid
4 mm MRI
2 Spontaneous Cribriform
plate
10 mm CT
3 Spontaneous Cribriform
plate
20 mm CT
4 Traumatic Ethmoid roof 4 mm CT-C
BRS meeting 2013
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BRS meeting 2013
BRS meeting 2013
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Technique
Moffet’s solution
One dose antibiotic on induction
Identify site of CSF leak and prepare the bed
TissuePatchDural (OBEX) film applied (overlay)
Tiseel applied as a second layer
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BRS meeting 2013
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Results
All female patients
Age- 49.5 years (43 to 58 years)
Intra operative handling – Easy
Preparation time - Ready to use
Operative time- Mean 40 minutes
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Results
Mean follow up 12 months ( 9-24 months)
No post-operative complications
No post opeartive CSF leak (100% success)
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Conclusion
Novel technique
Purely synthetic and absorbable
Adhesive property makes handling easier
Avoids morbidity and increased operating
times
BRS meeting 2013
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Thank You
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