Correspondence Endoscopic repair of CSF rhinorrhea: Necessity of fibrin glue
Alper Nabi Erkan
First of all we would like to thank Erkan et al.,[1] for reading our paper in detail. We have gone through their comments carefully.[2] In our study,[3] we have mentioned about their article in relation to histopathological changes which took place after application of fibrin glue. Though our study was based on pediatric population, nowhere we have mentioned that these changes were observed in human beings. Observation of these changes in human beings are difficult due to ethical considerations. In our department,[3,4] we have been performing endoscopic closure of cerebrospinal fluid rhinorrhea with and without fibrin glue for the past many years and we have not observed any such adverse reactions like mucosal damage, increased mucosal thickness, decreased perichondrial thickness and cartilaginous thickness, and segmental cartilage loss. In our study, the rate of recurrent csf rhinorrhea in patients where fibrin glue was used, was marginally more than the non‑glue group but the results were not statistically significant. As far as mentioning your article in relation to csf rhinorrhea is concerned, we do regret that, but we would like to draw your attention to your article where in introduction (first paragraph) you have mentioned the use of fibrin glue for various surgeries including csf rhinorrhea. The source of this observation has not been mentioned. Admittedly, we have presented a small series of patients and a larger series of patients and a systematically planned case‑control study is required to definitely address the questions which are still remaining.
Department of Otorhinolaryngology, Baskent University, Ankara/Turkey E‑mail: [email protected]
Satyawati Mohindra, Sandeep Mohindra1, Karan Gupta
Sir We read the article tittled “Endoscopic repair of cerebrospinal fluid (CSF) rhinorrhea: Necessity of fibrin glue” by Mohindra et al.[1] in your journal. Before all else we thank them to cite our article.[2] In our clinical research, at first we tried to detect the effects of fibrin glue on nasal septal tissues in nasal septal deviation operations. We did not practice in CSF leak operations. The two operations are different. We did the resarch on rabbits, not on human. Our results demonstrated that fibrin glue causes distinctive inflammation, creates mucosal damage, increases mucosal thickness, decreases perichondrial thickness and cartilaginous thickness, and causes segmental cartilage loss in rabbits but we do not say anything about the effects of fibrin glue on human according to our investigation. Habesoglu et al.[3] researched the effects of fibrin glue in septal deviation operations on human and they did not report any side effects. In addition to this, they reported that fibrin glue promotes the regeneration of mucociliary activity of the injured mucosa postoperatively. According to our oppinion, further comparative clinical investigations are required to assess the clinical efficacy of fibrin glue in CSF leak operations and Mohindra and his colleaques’[1] research will serve as the basis for new investigations.
Departments of Otolaryngology and Head and Neck Surgery, and 1Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India E‑mail: [email protected]
References 1. 2. 3.
Mohindra S, Mohindra S, Gupta K. Endoscopic repair of CSF rhinorrhea: Necessity of fibrin glue. Neurol India 2013;61:396‑9. Erkan AN, Cakmak O, Kocer NE, Yılmaz I. Effects of fibrin glue on nasal septal tissues. Laryngoscope 2007;117:491‑6. Habesoglu TE, Kulekci S, Habesoglu M, Deveci I, Deveci S, Toros S, et al. Comparative outcomes of using fibrin glue in septoplasty and its effect on mucociliary activity. Otolaryngol Head Neck Surg 2010;142:394‑9. Access this article online Quick Response Code:
Website: www.neurologyindia.com PMID: *** DOI: 10.4103/0028-3886.125425
References 1. 2. 3. 4.
Erkan AN, Cakmak O, Kocer NE, Yılmaz I. Effects of fibrin glue on nasal septal tissues. Laryngoscope 2007;117:491‑6. Erkan AN. Comment on "Susceptibility-weighted imaging: The value in cerebral astrocytomas" Neurol India 2014 [In this issue]. Mohindra S, Mohindra S, Gupta K. Endoscopic repair of CSF rhinorrhea: Necessity of fibrin glue. Neurol India 2013;61:396‑9. Yadav JS, Mohindra S, Francis AA. CSF rhinorrhea‑feasibility of conservative management in children. Int J Pediatr Otorhinolaryngol 2011;75:186‑9. Access this article online Quick Response Code:
Received: 25-09-2013 Review completed: 08-10-2013 Accepted: 30-12-2013
Authors reply
Website: www.neurologyindia.com
Sir Neurology India | Nov-Dec 2013 | Vol 61 | Issue 6
703
Copyright of Neurology India is the property of Medknow Publications & Media Pvt. Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
Alper Nabi Erkan
First of all we would like to thank Erkan et al.,[1] for reading our paper in detail. We have gone through their comments carefully.[2] In our study,[3] we have mentioned about their article in relation to histopathological changes which took place after application of fibrin glue. Though our study was based on pediatric population, nowhere we have mentioned that these changes were observed in human beings. Observation of these changes in human beings are difficult due to ethical considerations. In our department,[3,4] we have been performing endoscopic closure of cerebrospinal fluid rhinorrhea with and without fibrin glue for the past many years and we have not observed any such adverse reactions like mucosal damage, increased mucosal thickness, decreased perichondrial thickness and cartilaginous thickness, and segmental cartilage loss. In our study, the rate of recurrent csf rhinorrhea in patients where fibrin glue was used, was marginally more than the non‑glue group but the results were not statistically significant. As far as mentioning your article in relation to csf rhinorrhea is concerned, we do regret that, but we would like to draw your attention to your article where in introduction (first paragraph) you have mentioned the use of fibrin glue for various surgeries including csf rhinorrhea. The source of this observation has not been mentioned. Admittedly, we have presented a small series of patients and a larger series of patients and a systematically planned case‑control study is required to definitely address the questions which are still remaining.
Department of Otorhinolaryngology, Baskent University, Ankara/Turkey E‑mail: [email protected]
Satyawati Mohindra, Sandeep Mohindra1, Karan Gupta
Sir We read the article tittled “Endoscopic repair of cerebrospinal fluid (CSF) rhinorrhea: Necessity of fibrin glue” by Mohindra et al.[1] in your journal. Before all else we thank them to cite our article.[2] In our clinical research, at first we tried to detect the effects of fibrin glue on nasal septal tissues in nasal septal deviation operations. We did not practice in CSF leak operations. The two operations are different. We did the resarch on rabbits, not on human. Our results demonstrated that fibrin glue causes distinctive inflammation, creates mucosal damage, increases mucosal thickness, decreases perichondrial thickness and cartilaginous thickness, and causes segmental cartilage loss in rabbits but we do not say anything about the effects of fibrin glue on human according to our investigation. Habesoglu et al.[3] researched the effects of fibrin glue in septal deviation operations on human and they did not report any side effects. In addition to this, they reported that fibrin glue promotes the regeneration of mucociliary activity of the injured mucosa postoperatively. According to our oppinion, further comparative clinical investigations are required to assess the clinical efficacy of fibrin glue in CSF leak operations and Mohindra and his colleaques’[1] research will serve as the basis for new investigations.
Departments of Otolaryngology and Head and Neck Surgery, and 1Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India E‑mail: [email protected]
References 1. 2. 3.
Mohindra S, Mohindra S, Gupta K. Endoscopic repair of CSF rhinorrhea: Necessity of fibrin glue. Neurol India 2013;61:396‑9. Erkan AN, Cakmak O, Kocer NE, Yılmaz I. Effects of fibrin glue on nasal septal tissues. Laryngoscope 2007;117:491‑6. Habesoglu TE, Kulekci S, Habesoglu M, Deveci I, Deveci S, Toros S, et al. Comparative outcomes of using fibrin glue in septoplasty and its effect on mucociliary activity. Otolaryngol Head Neck Surg 2010;142:394‑9. Access this article online Quick Response Code:
Website: www.neurologyindia.com PMID: *** DOI: 10.4103/0028-3886.125425
References 1. 2. 3. 4.
Erkan AN, Cakmak O, Kocer NE, Yılmaz I. Effects of fibrin glue on nasal septal tissues. Laryngoscope 2007;117:491‑6. Erkan AN. Comment on "Susceptibility-weighted imaging: The value in cerebral astrocytomas" Neurol India 2014 [In this issue]. Mohindra S, Mohindra S, Gupta K. Endoscopic repair of CSF rhinorrhea: Necessity of fibrin glue. Neurol India 2013;61:396‑9. Yadav JS, Mohindra S, Francis AA. CSF rhinorrhea‑feasibility of conservative management in children. Int J Pediatr Otorhinolaryngol 2011;75:186‑9. Access this article online Quick Response Code:
Received: 25-09-2013 Review completed: 08-10-2013 Accepted: 30-12-2013
Authors reply
Website: www.neurologyindia.com
Sir Neurology India | Nov-Dec 2013 | Vol 61 | Issue 6
703
Copyright of Neurology India is the property of Medknow Publications & Media Pvt. Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
