KeypointsTissuePatchDural™ is an easy to store and apply synthetic cerebrospinal fluid (CSF) sealant.Its breakdown products are naturally occurring and non‐toxic.Its use appears safe in the middle ear.It is shown to successfully close mastoid CSF leaks.Its use as an adjunct in sealing middle ear fistulae is also demonstrated.Dear Editor,Tissue Patch Dural™ is a synthetic Cerebrospinal Fluid (CSF) sealant used most commonly by neurosurgeons. Its use has previously been reported in the anterior skull base by ENT surgeons. We have found it a useful material to have available during middle ear and mastoid surgery and have not identified any publications reporting its potential applications here. We describe our experience.The proximity of the middle and posterior cranial fossa dura to the mastoid cavity makes it vulnerable both to disease and instrumentation during mastoid surgery. Breach of the dura will result in a CSF leak, which may present as CSF otorrhoea, otorhinorrhoea or meningitis if not repaired. Most causes of CSF leaks are acquired. Iatrogenic causes are more common than trauma. CSF leakage into the middle ear is a recognised complication of trans‐mastoid lateral skull base surgery and less commonly occurs as a result of mastoid explorations and approaches to the petrous apex.
Clinical Otolaryngology – Wiley
Published: Jan 1, 2018
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