Efficacy and Safety of Using N-Butyl Cyanoacrylate in Cranial Fixation Following Trauma and Other Pathologies.

Abstract

Skull bone fixation following different cranial surgeries is essential and should be rigid, simple and cheap. We describe our technique of cranial fixation using the adhesive cyanoacrylates. At the end of cranial and intracranial surgeries the craniotomy flap and bone pieces are returned, realigned and fixed using HistoacrylŽ (N-Butyl Cyanoacrylate) glue. The glue is applied all around the flap in 360-degree fashion. The adhesive material was used in 24 cases after different surgeries involving the calvaria of the skull. Patient age ranged from 1 month to 55 years. Seven cases presented with depressed fractures, 5 traumatic hematomas, and 2 cases after decompressive craniotomies for malignant middle cerebral artery (MCA) infarctions, and 10 cases operated for brain tumors. No skin or bone flap infections were encountered during the follow up period and fusion of the edges of bone flap was observed on follow-up imaging in most of the cases. Skull bone realignment and fixation using glue is a simple, safe, and inexpensive method. The operative procedure was not prolonged. Good cosmetic appearance and realignment and fusion of the bone flap were achieved. Further neuroimaging methods are not prohibited. Glue is suitable for the growing skull of children. Glue is also suitable in compound depressed fractures of the skull with possibility of infection.