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Sinonasal outcomes associated with the use of BioGlue® in endoscopic transsphenoidal pituitary surgery

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Abstract

Concerns have been raised in the neurosurgical literature regarding the use of BioGlue®, a tissue sealant initially developed for cardiothoracic surgery, due to reports of an increased incidence of infection, wound breakdown, and CSF fistulae. The aim of this study was to determine if the use of BioGlue® in skull base repair impacts on the sinonasal outcomes and the incidence of post-operative infection following endoscopic pituitary surgery. SNOT-22 questionnaires were completed pre-operatively, and at 6, 12, and 24 weeks post-operatively by 50 patients. Pre- and post-operative MRI scans were reviewed and assessed for evidence of post-operative sinusitis. Patient records were consulted to ascertain the incidence of post-operative infection. Repeated measures ANOVA and Wilcoxon signed rank test were used for data analysis. Statistical analysis revealed a significant difference in the mean SNOT-22 scores across the four time intervals (F(1.605, 78.642) = 9.180, p = 0.001). This difference was powered by a deterioration at 6 weeks that recovered completely by 12 weeks. The mean SNOT-22 score in the study cohort at 24 weeks was 16.84/110 (range 0–57, ± 2.04) which was lower than the mean pre-operative score and is consistent with mild rhinosinusitis. There were no cases of post-operative meningitis and 1/50 (2%) case of post-operative sinusitis in this cohort. The use of BioGlue® in endoscopic endonasal pituitary surgery does not appear to lead to significant sinonasal morbidity. Previous concerns about the use of BioGlue® in transcranial procedures may not apply to extradural application of this tissue sealant in endoscopic transnasal surgery.

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Anonymized data available upon request.

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Authors and Affiliations

  1. Department of Neurosurgery, Manchester Centre for Clinical Neurosciences, Manchester, England

    Cathal John Hannan

  2. National Neurosurgical Centre, Beaumont Hospital, Dublin, Ireland

    Deirdre Nolan, Paula Corr, Michael Amoo, Daniel Murray & Mohsen Javadpour

  3. Department of Neuroradiology, Beaumont Hospital, Dublin, Ireland

    Seamus Looby

  4. Royal College of Surgeons in Ireland, Dublin, Ireland

    Michael Amoo, Daniel Murray, Seamus Looby & Mohsen Javadpour

  5. Department of Academic Neurology, Trinity College Dublin, Dublin, Ireland

    Mohsen Javadpour

Authors
  1. Cathal John Hannan
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  2. Deirdre Nolan
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  3. Paula Corr
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  4. Michael Amoo
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  5. Daniel Murray
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  7. Mohsen Javadpour
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Contributions

Study conception: MJ, SL.

Data collection: DN, PC, MA, DM.

Data analysis: CJH.

Review of manuscript: CJH, DN, PC, MA, DM, SL, MJ.

Corresponding author

Correspondence to Mohsen Javadpour.

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This work was approved by our institutional review board.

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Only fully anonymized data was utilized, and the necessity for individual patient consent was waived, as per our institutional policy.

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The authors declare no competing interests.

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Previous presentations

Portions of this work were presented previously at the 2020 British Skull Base Society Meeting in London, England

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Hannan, C.J., Nolan, D., Corr, P. et al. Sinonasal outcomes associated with the use of BioGlue® in endoscopic transsphenoidal pituitary surgery. Neurosurg Rev 45, 2249–2256 (2022). https://doi.org/10.1007/s10143-021-01723-x

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  • DOI: https://doi.org/10.1007/s10143-021-01723-x

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