Experimental and Clinical Evaluation of Spongostan as a Substitute for Spongel in Sellar Floor Reconstruction during Endoscopic Transsphenoidal Surgery.

Abstract

Absorbable gelatin sponges are widely used as hemostatic and reconstructive materials in neurosurgery. Global discontinuation of Gelfoam and withdrawal of Spongel from the Japanese market have created an urgent need for alternatives. This study was performed to evaluate the utility of Spongostan as a substitute for Spongel and Gelfoam in sellar floor reconstruction using the fibrin glue-soaked gelatin sponge method.Two gelatin sponges (Spongel and Spongostan) and 2 fibrin sealants (Beriplast and Bolheal) were combined to prepare 4 fibrin glue-soaked gelatin sponge combinations. Adhesive strength was measured using a tensile strength test according to ASTM F2458-05 and analyzed using 2-way analysis of variance. A retrospective review was also conducted for patients who underwent endoscopic transsphenoidal surgery for pituitary adenoma between May 2024 and October 2025, in which fibrin glue-soaked gelatin sponge prepared with Spongostan was used for sellar floor reconstruction.Spongostan showed significantly higher adhesive strength than Spongel (F (1,20) = 13.72, p = 0.0014), whereas neither the fibrin sealant type nor the sponge-fibrin sealant interaction was significant (both p = 0.73). In 11 clinical cases (mean age 66 ± 16 years), intraoperative cerebrospinal fluid leakage occurred in 5 cases and postoperative leakage in one case, in a patient who had undergone prior radiotherapy. No hemorrhage, meningitis, or material-related complications occurred. These findings suggest that Spongostan may serve as a feasible alternative to Spongel for fibrin glue-soaked gelatin sponge-based sellar floor reconstruction during endoscopic transsphenoidal surgery.