[The use of fibrin glue in neurosurgical operations]

Fibrin glue has been used in 22 neurosurgical patients and following five effects which are very much helpful in neurosurgical practice were recognized. Adhesive effect--Dural defect at cranial base was closed with lyophilized dura and fibrin glue. Hemostatic effect--Fibrin glue soaked oxycel was applied for hemostasis of the bleeding from venous sinus, dura, skull edge and cut surface of tumor. Blocking and sealing effects--In cases of craniopharyngioma, cyst wall around the inserted tube was sealed with oxycel and fibrin glue. CSF leakage from open sphenoidal sinus in aneurysmal operation was closed with fibrin glue soaked gelfoam. Covering and wall strengthening effects--Unclippable aneurysms were coated and wrapped with fibrin glue and oxycel. Packing effect--Huge dead space after removal of mucocele was packed with fibrin glue. In trans-sphenoidal operation of pituitary adenoma, fibrin glue soaked muscle pieces and oxycel were packed in the dead space and sphenoidal sinus. Many other possible availabilities in neurosurgical operations were discussed. Fibrin glue is a biological product, so it can be used with more safety and affinity to the local tissue and with less reaction as foreign body than the artificial adhesives. It takes much time for the preparation of this material for the time being. If this can be prepared instantly, usefulness of this glue will be markedly increased. We have had no hepatitis nor inflammatory complications in our limited experience.