Abstract
Cerebrospinal fluid (CSF) leaks complicate up to 30% of skull base operations. Current surgical adhesives for CSF leak repair are limited by poor adhesion in dynamic and aqueous environments and an inability to reconstruct large cranial defects that span multiple types of tissue. In contrast, tough adhesives are a novel hydrogel coated with an adhesive bridging polymer that provides high performance as a sealant within biological fluids. This novel technology demonstrates extraordinary mechanical toughness, capacity to repeatedly withstand significant strain, and the ability to bind strongly to wet surfaces. However, their application to dural tissue has not been investigated. The purpose of this study was to investigate the use of this novel biomaterial for dural reconstruction and CSF leak prevention. We hypothesized that tough adhesives will exhibit a greater burst pressure compared with existing commercial sealants.