Failure pressures after repairs of 2-cm × 2.5-cm rhinologic dural defects in a porcine ex vivo model.

Autor: Lin RP; Uniformed Services University of Health Sciences and San Antonio Uniformed Health Sciences Educational Consortium, Joint Base San Antonio, TX.; Department of Otolaryngology-Head and Neck Surgery, University of Texas Health Science Center San Antonio, San Antonio, TX.; Department of Anesthesiology, University of Texas Health Science Center San Antonio, San Antonio, TX., Weitzel EK; Uniformed Services University of Health Sciences and San Antonio Uniformed Health Sciences Educational Consortium, Joint Base San Antonio, TX., Chen PG; Department of Otolaryngology-Head and Neck Surgery, University of Texas Health Science Center San Antonio, San Antonio, TX. p_g_chen@hotmail.com., McMains KC; Uniformed Services University of Health Sciences and San Antonio Uniformed Health Sciences Educational Consortium, Joint Base San Antonio, TX., Chang DR; Department of Otolaryngology-Head and Neck Surgery, University of Texas Health Science Center San Antonio, San Antonio, TX., Braxton EE; Uniformed Services University of Health Sciences and San Antonio Uniformed Health Sciences Educational Consortium, Joint Base San Antonio, TX., Majors J; Uniformed Services University of Health Sciences and San Antonio Uniformed Health Sciences Educational Consortium, Joint Base San Antonio, TX., Bunegin L; Department of Anesthesiology, University of Texas Health Science Center San Antonio, San Antonio, TX.
Jazyk: angličtina
Zdroj: International forum of allergy & rhinology [Int Forum Allergy Rhinol] 2016 Oct; Vol. 6 (10), pp. 1034-1039. Date of Electronic Publication: 2016 Jun 09.
DOI: 10.1002/alr.21804
Abstrakt: Background: The objective of this study was to determine failure pressures of 6 rhinologic repair techniques of large skull base/dural defects in a controlled, ex vivo model.
Methods: Failure pressures of 6 dural repairs in a porcine model were studied using a closed testing apparatus; 24-mm × 19-mm dural defects were created; 40-mm × 34-mm grafts composed of porcine Duragen (Integra), fascia lata, and Biodesign (Cook) were used either with or without Tisseel (Baxter International Inc.) to create 6 repairs: Duragen/no glue (D/NG), Duragen/Tisseel (D/T), fascia lata/no glue (FL/NG), fascia lata/Tisseel (FL/T), Biodesign/no glue (B/NG), and Biodesign/Tisseel (B/T). Saline was infused at 30 mL/hour, applying even force to the underside of the graft until repair failure. Five trials were performed per repair type for a total of 30 repairs.
Results: Mean failure pressures were as follows: D/NG 1.361 ± 0.169 cmH 2 O; D/T 9.127 ± 1.805 cmH 2 O; FL/NG 0.200 ± 0.109 cmH 2 O; FL/T 7.833 ± 2.657 cmH 2 O; B/NG 0.299 ± 0.109 cmH 2 O; and B/T 2.67 ± 0.619 cmH 2 O. There were statistically significant differences between glued (Tisseel) and non-glued repairs for each repair category (p < 0.05).
Conclusion: All glued repairs performed better than non-glued repairs. Both D/T and FL/T repairs performed better than B/T repairs. No repair tolerated pressures throughout the full range of adult supine intracranial pressure.
(© 2016 ARS-AAOA, LLC.)
Databáze: MEDLINE
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