Abstract
Objective This study was aimed to compare the safety profiles, magnetic resonance imaging (MRI)
findings, and sinonasal outcome test (SNOT-22) scores of Adherus dural sealant, a
novel tissue glue designed for skull base surgery.
Design Present study is a prospective case series.
Setting The research work took place at a tertiary-care academic medical center.
Participants Consecutive series of 26 patients undergoing endoscopic skull base surgery (ESBS)
with Adherus was compared with a control group of 24 patients matched for tumor type
and size with DuraSeal as a sealant.
Main Outcome Measures Postoperative complication rates, imaging characteristics, and postoperative SNOT-22
scores were measured and compared.
Results No postoperative cerebrospinal fluid (CSF) leaks, intracranial hemorrhages, or mucoceles
were observed in either cohort. Adherus was more likely to be identifiable on immediate
postoperative MRI (50 vs. 20.8%, p = 0.032). In patients in whom a nasoseptal flap was utilized, the flap was opposed
to the skull base in all cases regardless of sealant selected. Postoperative SNOT-22
total (17.25 [±10.81] vs. 14.85 [±14.22], p = 0.609) and subdomain scores were similar between the two groups.
Conclusions Adherus dural sealant appears to be a safe alternative to Duraseal in ESBS with comparable
quality of life outcomes and imaging findings. These preliminary results are promising
but should be examined in a larger population with long-term follow-up.
Keywords
skull base repair - quality of life - imaging - dural sealant - Duraseal - Adherus
- nasoseptal flap
