{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T12:15:54Z","timestamp":1773922554769,"version":"3.50.1"},"reference-count":15,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2012,10,25]],"date-time":"2012-10-25T00:00:00Z","timestamp":1351123200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int Forum Allergy Rhinol"],"published-print":{"date-parts":[[2013,3]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The purpose of this work was to compare the absolute breaking strength of various soft tissue skull base (SB) repairs in an in vitro porcine model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A burst pressure (BP) testing system was designed using an axial loading force to create increasing hydraulic pressure. Defects measuring 0.5 \u00d7 0.5\u2009cm were created in fascia lata samples. Defects were repaired using various grafts (pericranium and 2\u2009different dural substitutes, Alloderm\u00ae and Durasis\u00ae) measuring 1.0 \u00d7 1.0\u2009cm to cover the deficient area. Grafts were further reinforced onto the fascia background with either fibrin glue (Tisseel\u00ae) or hydrogel sealant (DuraSeal\u2122). Each combination of graft and sealant was conducted 6\u2009times and tested 24\u2009hours after the repair.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean BP (\u00b1standard deviation [SD]) were as follows: DuraSeal\u2122\u2010Alloderm, 12.5 \u00b1 5.8\u2009mmHg; DuraSeal\u2122\u2010Durasis, 21.8 \u00b1 20.7\u2009mmHg; DuraSeal\u2122\u2010pericranium, 44.7 \u00b1 30.1\u2009mmHg; Tisseel\u2010Alloderm, 30.6 \u00b1 26.3\u2009mmHg; Tisseel\u2010Durasis, 15.8 \u00b1 18.6\u2009mmHg; and Tisseel\u2010pericranium, 95.5 \u00b1 86\u2009mmHg. One\u2010way analysis of variance showed that the strongest type of repair was Tisseel\u2010pericranium when adjusting for the others (<jats:italic>p<\/jats:italic> &lt; 0.0001). The difference in mean BP of repair with DuraSeal\u2122 vs Tisseel\u00ae was not statistically significant (<jats:italic>p<\/jats:italic> = 0.22). Comparing sealants, the use of Alloderm\u00ae or Durasis\u00ae decreased the strength of the repair in comparison to pericranium (<jats:italic>p<\/jats:italic> &lt; 0.0001). Bonferroni analysis showed a significant difference between pericranium and Alloderm\u00ae (<jats:italic>p<\/jats:italic> &lt; 0.05) and between pericranium and Durasis\u00ae (<jats:italic>p<\/jats:italic> &lt; 0.05) but not between Alloderm\u00ae and Durasis\u00ae (<jats:italic>p<\/jats:italic> &gt; 0.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In this model, the strongest type of repair (pressure 6\u2009times higher than normal intracranial pressure) was the combination of Tisseel\u00ae\u2010pericranium. Our data will help guide surgeons who repair SB defects to choose the best graft and sealant.<\/jats:p><\/jats:sec>","DOI":"10.1002\/alr.21085","type":"journal-article","created":{"date-parts":[[2012,10,25]],"date-time":"2012-10-25T20:41:12Z","timestamp":1351197672000},"page":"212-216","source":"Crossref","is-referenced-by-count":19,"title":["Determining the best graft\u2010sealant combination for skull base repair using a soft tissue in vitro porcine model"],"prefix":"10.1002","volume":"3","author":[{"given":"Marcela","family":"Fandi\u00f1o","sequence":"first","affiliation":[{"name":"Otolaryngology\u2013Head and Neck Surgery Mount Sinai Hospital  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristian","family":"Macdonald","sequence":"additional","affiliation":[{"name":"Otolaryngology\u2013Head and Neck Surgery Mount Sinai Hospital  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Devin","family":"Singh","sequence":"additional","affiliation":[{"name":"Orthopaedic Biomechanics Laboratory Sunnybrook Research Institute  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cari","family":"Whyne","sequence":"additional","affiliation":[{"name":"Orthopaedic Biomechanics Laboratory Sunnybrook Research Institute  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ian","family":"Witterick","sequence":"additional","affiliation":[{"name":"Otolaryngology\u2013Head and Neck Surgery Mount Sinai Hospital  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2012,10,25]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-323-05283-2.00055-0"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1977.46.2.0215"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.22475"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200007000-00019"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.2165\/00003495-199958050-00010"},{"key":"e_1_2_7_7_1","first-page":"106","article-title":"Testing biomechanical strength of in vitro cerebrospinal fluid leak repairs","volume":"38","author":"de Almeida JR","year":"2009","journal-title":"J Otolaryngol Head Neck Surg"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2009.03.008"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200402000-00015"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-970556"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0029-1246161"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2012.01.009"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.3171\/foc.2005.19.1.9"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1067\/mhn.2000.107452"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.2500\/ajra.2009.23.3293"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.20022"}],"container-title":["International Forum of Allergy &amp; Rhinology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Falr.21085","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/alr.21085","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,30]],"date-time":"2023-10-30T06:10:46Z","timestamp":1698646246000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/alr.21085"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,10,25]]},"references-count":15,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2013,3]]}},"alternative-id":["10.1002\/alr.21085"],"URL":"https:\/\/doi.org\/10.1002\/alr.21085","archive":["Portico"],"relation":{},"ISSN":["2042-6976","2042-6984"],"issn-type":[{"value":"2042-6976","type":"print"},{"value":"2042-6984","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,10,25]]}}}