Efficacy of Ethyl 2-Cyanoacrylate in Nasal Surgery

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  • Hirai Tomohisa
    Department of Otorhinolaryngology, Head and Neck Surgery, Hiroshima Prefectural Hospital
  • Fukushima Noriyuki
    Department of Otorhinolaryngology, Head and Neck Surgery, Hiroshima Prefectural Hospital
  • Go Keishin
    Department of Otorhinolaryngology, Head and Neck Surgery, Hiroshima Prefectural Hospital
  • Sato Yuki
    Department of Otorhinolaryngology, Head and Neck Surgery, Hiroshima Prefectural Hospital
  • Fujita Rikuto
    Department of Otorhinolaryngology, Head and Neck Surgery, Hiroshima Prefectural Hospital
  • Masuda Shin
    Department of Pediatric Rehabilitation, Hiroshima Prefectural Hospital
  • Nishida Manabu
    Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Biomedical Sciences, Hiroshima University

Bibliographic Information

Other Title
  • 鼻内手術におけるエチル2-シアノアクリレートの有用性
  • ハナ ナイ シュジュツ ニ オケル エチル 2-シアノアクリレート ノ ユウヨウセイ

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Abstract

<p>　Cyanoacrylate-based adhesives known as instant glue have been used over the last 50 years in medical practice for various purposes such as achieving skin adhesion, hemostasis, vascular anastomosis, fistula closure, etc. The adhesive hardens within a few minutes, and has a strong adhesive effect. However, there is no report of the use of a cyanoacrylate-based adhesive in endoscopic sinus surgery. The advantage of ethyl 2-cyanoacrylate (ECA) is that it has a low viscosity, so that it can dropped into deep target areas in the nasal cavity and paranasal sinuses. Furthermore, the cost of ECA is lower than that of any other cyanoacrylate-based adhesives, and it is not necessary to obtain written consent for the use of blood products.</p><p></p><p>　We present our initial experience of the use of ECA adhesive using a syringe equipped with a fine needle for closure of the mucosal incision in submucous resection of the inferior nasal concha, immobilization of the batten graft in nasal septal surgery and fixation of oxycell cotton in cases of intractable hemorrhage.</p><p></p><p>　The adhesion rate of the mucosal flap in submucous resection of the inferior nasal concha was 92.9% (367/393 sides in 234 cases). On the other hand, the rate of closure by suture with 4-0 PDS® was 92.9% (269/326 sides in 165 cases). Thus, there was a significant difference in the success rate between the ECA-adhesive group and the 4-0 PDS®-suture group (P<0.05).</p><p></p><p>　In nasal septal surgery for cases with caudal end deviation, fixing of the batten graft to the anterior nasal spine is difficult with the currently available techniques. We adopted the hemitransfixion approach and in order to correct the deviation of the caudal end, we rebuilt the caudal end with a batten graft and reinforced it by dropping ECA in 31 cases. The correction was accomplished well and there were no cases of recurrence of deviation.</p><p></p><p>　For 18 sides in 14 cases with intractable hemorrhage, we dropped ECA in the oxycellulose cotton which was placed at bleeding sites for the purpose of fixation, and good hemostasis was obtained, with no cases of re-bleeding.</p><p></p><p>　No serious cases of infection or foreign body reaction were observed.</p><p></p><p>　We concluded that ethyl 2-cyanoacrylate is useful for various purposes in nasal surgery.</p>

Journal

  • Nippon Jibiinkoka Gakkai Kaiho

    Nippon Jibiinkoka Gakkai Kaiho 123 (7), 572-579, 2020-07-20

    Japanese Society of Otorhinolaryngology-Head and neck surgery

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