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26-OCTOBER-2015 FAYSAL IZZAT AL-ZIBDIYEH 72 YEARS
RECURRENT CSF LEAK AFTER REPAIR WITH LYODURA APPLICATION AND GLUBRAN 2
DAYS AGO.
Anamnesis
The patient was operated by me 2 days ago for
massive CSF leak and repair of the dura with
application of lyodura with Glubran was applied.
The patient was doing well and walked the same
day. At the early morning of this day, CSF came
out of the wound and it was decided to do
revision of the wound.
The old wound refreshed. A
bloody collection came out and the patient was
put in Valsalva maneuver and it was noticed that
a mild CSF came out through the Glubran in the
left lower corner of the wound. The lyodura and
the Glubran were in place. Glubran was added to
this point and a piece of muscle was applied
over it. Glubran was applied over this layer.
A muscle with pedicle was applied from the left
side and brought over the field and Glubran
applied over it. Another muscle with pedicle was
brought from the right side and Glubran applied
over it. At all stages Valsalva maneuver was
negative. At last a big piece of subcutaneous
fat tissue was brought to snugly fill the
cavity. Water-tight closure of all layers.
Smooth postoperative recovery. He was sent to the ward.
Comments
The patient has persistent CSF leak with
huge amount, which necessitate exploration. Recurrence
mandate re-exploration.
In case this case a demonstration that
Glubran is inferior to previous versions of Glues which
disappeared from the market 15-20 years ago.
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