Zusammenfassung
Die Entwicklung von Gewebeklebstoffen hat in der Medizin eine lange
Geschichte, ohne dass ein universell einsetzbarer Klebstoff für den
klinischen Alltag gefunden werden konnte. Gründe hierfür sind die
spezifischen Anforderungen, die an einen Gewebeklebstoff gestellt werden, und
die unterschiedlichen Anwendungsgebiete. Im HNO-Gebiet sind das zum einen das
Schleimhautmilieu, aber auch die Anwendung im Bereich des Knochens, Knorpels
und der peripheren Nerven, zum anderen finden sich belastete Regionen (Haut,
Mundhöhle, Pharynx, Oesophagus, Trachea) und unbelastete Regionen
(Mittelohr, Nase/NNH, Schädelknochen). Da der Klebstoff aber deutliche
Vorteile in der Sicherung von Operationsergebnissen, bei der Vorbeugung von
Komplikationen und damit eine Reduktion von Behandlungskosten bringen kann,
wird die Suche nach Gewebeklebstoffen zur Nutzung im HNO-Bereich intensiv
weitergeführt werden. Parallel dazu müssen geeignete
Applikationssysteme für den mikroskopischen und endoskopischen Einsatz
entwickelt werden.
Abstract
The development of medical tissue adhesives has a long history
without finding an all-purpose tissue adhesive for clinical daily routine. This
is caused by the specific demands which are made on a tissue adhesive, and the
different areas of application. In otorhinolaryngology, on the one hand, this
is the mucosal environment as well as the application on bones, cartilage and
periphery nerves. On the other hand, there are stressed regions (skin, oral
cavity, pharynx, oesophagus, trachea) and unstressed regions (middle ear, nose
and paranasal sinuses, cranial bones). But due to the facts that adhesives can
have considerable advantages in assuring surgery results, prevention of
complications and so reduction of medical costs/treatment expenses, the search
for new adhesives for use in otorhinolaryngology will be continued intensively.
In parallel, appropriate application systems have to be developed for
microscopic and endoscopic use.
Schlüsselwörter
Gewebeklebstoffe - Cyanoacrylate - Fibrinklebstoff - GRG/GRF-Klebstoffe - Albumin-Glutaraldehydklebstoffe - Applikatoren
Key words
tissue adhesives - cyanoacrylates - fibrin glue - GRG/GRF glue - albumin glutaraldehyde glue - applicators
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Dr. med. Gerlind Schneider
Klinik für Hals-, Nasen- und Ohrenheilkunde,
Universitätsklinikum Jena
Lessingstraße 2
07743 Jena
Email: gschneider@med.uni-jena.de
