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Failure pressures of three rhinologic dural repairs in a porcine ex vivo model
Ryan P Lin1,2,3, Erik Kent Weitzel1, Philip G Chen2
1Uniformed Services, University of Health Sciences and San Antonio Uniformed Health Sciences Educational Consortium, Joint Base San Antonio, San Antonio, TX, USA.
Background:
The objective of this work was to determine the failure pressures of 3 commonly performed repair techniques of 5-mm dural defects in a controlled setting.
Methods:
This was a pig dura ex vivo study. A testing apparatus was fabricated to study failure pressures of 3 different repairs in a porcine model. Five-millimeter (5-mm) dural defects were created and plugged with autologous mucosa/Tisseel (MT) (Baxter International Inc.), fat graft (FG), and bath plug (BP) techniques. Saline solution was infused at 30 mL/hour to apply unidirectional pressure to the repair until failure occurred. Five dural repairs were performed for each arm of the trial, for a total of 15 trials.
Results:
The mean failure pressure of the MT repair was 4.3 ± 1.9 cmH2 O, of the FG repair was 10.9 ± 4.2 cmH2 O, and of the BP repair was 20.7 ± 2.2 cmH2 O. Differences among mean failure pressures were statistically significant.
Conclusion:
The BP repair showed significantly higher tolerances for pressure than the other 2 repairs. The BP repair was the only technique that withstood adult physiologic supine cerebrospinal fluid (CSF) pressure.
