NISHIHIRA Shigeki Ogachi Tyuuho Hospital, Doctor, 医師 (80180628)
ITO Eiko Akita Univ., ORL, Assistant, 医学部, 助手 (90006734)
HANAZAWA Shigeru Akita Univ., ORL, Assistant, 医学部, 助手 (20125735)
|Budget Amount *help
¥6,800,000 (Direct Cost: ¥6,800,000)
Fiscal Year 1990: ¥800,000 (Direct Cost: ¥800,000)
Fiscal Year 1989: ¥1,300,000 (Direct Cost: ¥1,300,000)
Fiscal Year 1988: ¥4,700,000 (Direct Cost: ¥4,700,000)
1) Experiments were performed to examine the effect of applying fibrin glue for the treatment of cerebrospinal (CSF) rhinorrhea, using an animal model. 39 rats were used for this purpose. Those were divided into four groups ;
1. no treatment control ; 2. fibrin adhesive alone ; 3. muscle packing alone ; 4. fibrin glue with muscle packing. Persistent CSF leakage was noted at 3 weeks after operation in 89% of group 1, 55% of group 2, 33% of group 3, and 22% of group 4. Thus results have shown that the use of fibrin glue adhesive with muscle packing provided the best result to close the rhinorrhea, but no satisfactory result was obtained by fibrin glue alone.
2) Post-transection sciatic nerve recovery was comparatively studied electrophysiologically between the group of nylon suture and the one of fibrin glue anastomosis in rats. Judging from the results of action potential, the use of use of fibrin glue adhesive was slightly less effective than nylon suture. But the success rate by visual
observation was 80% in fibrin adhesive and 100% in nylon suture for nerve grafts, and 100% in both groups for the simple neurectomy. Fibrin adhesive technigue may significantly successful for the nerve repair, but the addition of nylon suture will more successful than fibrin adhesive alone.
3) Evaluation of fibrin glue adhesive for experimental facial nerve anastomosis was carried out. The zygomaticopalpebral branch of the facial nerve in guinea pig was transected and repaired by either fibrin glue or nylon suture. Electrophysiologically, the recovery course of evoked electromyography and palpebral muscle contraction rate were studied, and no significant difference was obtained between the two groups. Histopathologically, foreign body reaction of the fibrin glue was slight, and fibrin glue was almost completely absorbed at the time of 4 weeks after the anastomosis. The use of fibrin glu adhesive of the facial nerve is useful, simple and less traumatic to the nerve.
4) Fibrin glue was used in 55 cases clinically. It has been applied to periosteum, mucosa, skin, muscle, nerve, vessels, fascia, ceramics, and hydrooxyapatites etc, for the purpose of sealing, adhesion, fixation, hemostasis, filling dead spaces, and controlling exsudate etc. None of the adverse effects such as infections, keroid formation, allergic reaction and liver dysfunction were developed as well. Thus these results were satisfactory. Accordingly, it could be concluded that glue is quite useful and safe adhesive. Less