ABSTRACT
In the past, three different cyanoacrylates were used as tissue adhesives for diverse surgical problems. Two of these, isobutyl-cyanoacrylate and methyl-methacrylate, create severe inflammation and tissue destruction in the middle and inner ear of dogs, guinea pigs, and cats; therefore, these two adhesives were considered unsuitable. The adhesive 2-butyl-cyano-acrylate or Histoacryl, which seemed to come closest to the requirements for an ideal tissue glue, was tested in the early 1970s. In clinical application, Histoacryl was used in fifty human tympanoplasty procedures: in myringoplasties, ossicular chain, and posterior canal reconstruction. Only minute quantities of the adhesive were used and little inflammation or no reactions were observed. Autologous fibrin tissue adhesive at present seems to be the best choice for a surgical adhesive in the United States.
