Fibrin tissue adhesive sealant for the prevention of CSF leakage following transsphenoidal microsurgery.

Fibrin glue (Beriplast, Behring or Tissucol, Immuno) was used for 126 sublabial transseptal transsphenoidal operations in 119 patients from April 1981 to March 1987 in a variety of sellar pathologies together with septal bone and spongycel to seal the sellar floor and the anterior wall of the sphenoid sinus. The incidence of postoperative rhinorrhea was 1.6%. A review of the literature revealed an incidence of 1.5%-9.6% with the use of autologous tissue for sellar packing such as fat or muscle; fibrin glue combined with autologous grafts led to postoperative rhinorrhea in 1%-4.4%. The present results support the view that sellar and sphenoidal sealing with fibrin glue instead of muscle or fat tissue does not raise the incidence of postoperative rhinorrhea.