Use of fibrin glue in maxillofacial surgery.

OBJECTIVE

To describe various applications of homologous fibrin glue in maxillofacial surgery. The clinical outcomes of the treated cases are discussed.

METHODS

During the period January 1993 to July 1995, 71 patients underwent maxillofacial procedures in which homologous fibrin glue was utilized. The material used in each case was Tisseel, which is composed of human fibrinogen and bovine thrombin. The material was used to provide close and secure re-approximation of soft tissue in 20 patients requiring coronal flaps. Bone or alloplast fixation was undertaken with fibrin sealant in 14 patients. In 13 cleft lip and palate patients, the material was used in the repair of residual fistulas or clefts. Twelve patients had sinus lift procedures where the material fixated the bone graft and repaired the torn mucoperiosteal lining. Finally, 12 patients with coagulopathies had fibrin glue placed following exodontia. All patients were followed for a minimum of 6 months postoperatively.

RESULTS

Seventy patients treated with Tisseel had successful outcomes as determined by preoperative criteria. A single oral antral fistula recurred 3 weeks after surgery. No adverse reaction to the material was noted in any of the patients.

CONCLUSIONS

Homologous fibrin glue has various applications in the field of maxillofacial surgery and can be used with safe and predictable results.