Use of medical aural and encephalic glue-soaked gelfoam for frontal sinus repair: a single-centre experience

Abstract

Background: Frontal sinus (FS) perforation is a common complication in frontal craniotomy. The primary goal of treatment is to seal the FS without destroying physiological function.

Objective: This article describes a new FS cavity reconstruction technique using medical aural and encephalic glue (EC glue)-soaked gelfoam.

Methods: Between 2007 and 2012, 118 patients underwent FS reconstruction using EC glue-soaked gelfoam. The FS cavity was reconstructed in all patients and no patient experienced intracranial infection, frontal sinusitis, or cerebrospinal fluid (CSF) leakage.

Results: Restoring physiological function is the primary goal of FS reconstruction. Difficulty often arises in sealing the sinus opening, especially when the mucosa is damaged. Mucosal border dissection and electric coagulation of the mucosal laceration can help to reconstruct the mucosal cavity. Sealing the sinus with autogenous or exogenous material, such as fascia, bone flap or gelfoam carries increased risks of intracranial infection, frontal sinusitis, and CSF leakage in the short term, and increased the occurrence of a FS mucocoele in the long term. Gelfoam saturated with EC glue obtained good results.

Conclusion: We describe the application of gelfoam saturated with EC glue to treat an open FS with or without mucosal violation during frontal craniotomy. Gelfoam saturated with EC glue is a quick, effective, low-cost and reliable means of sealing the FS while preserving its physiological function.

Keywords: CSF; CT; EC glue; FS; Frontal sinus; Gelfoam; MRI; Medical aural and encephalic glue; Reconstruction; cerebrospinal fluid; computed tomography; frontal sinus; magnetic resonance imaging; medical aural and encephalic glue.