Extracranial drainage of cerebrospinal fluid: a study of beta-transferrins in nasal and lymphatic tissues.
OBJECTIVE
To determine whether an alternative route of cerebrospinal fluid (CSF) drainage exists through the nasal mucosa and the cervical lymphatic system.


METHODS
A prospective study was carried out on 18 patients at a university teaching hospital.


METHODS
Ten patients undergoing routine endoscopic sinus surgeries and eight patients undergoing neck dissections were recruited for this study. Tissues were sampled from the middle turbinate, nasopharynx, and upper septum in the first group; jugulodigastric lymph nodes and nasopharyngeal tissues were obtained from the second group. Specimens were subjected to immunofixation electrophoresis in an attempt to identify the presence of beta-1 and beta-2 transferrins. Serum samples were obtained from each subject to serve as controls.


RESULTS
All tissue specimens contained beta-1 transferrin; none showed evidence of beta-2 transferrin.


CONCLUSIONS
Using this technique, an alternate route of CSF drainage through the nose and the cervical lymphatic system could not be confirmed. Nevertheless, a new technique of performing immunofixation in solid tissues for the purpose of beta-transferrin identification is described.
Solomon
P
P
Department of Otolaryngology, University of Toronto, Ontario, Canada.
Chen
J
J
D'Costa
M
M
Gilbert
R
R
Davidson
J
J
Johnston
M
M
D002559:Cerebrospinal Fluid Rhinorrhea / Q000175:diagnosis*; D046508:Culture Techniques; D004322:Drainage / Q000379:methods; D004724:Endoscopy / Q000379:methods; D005122:Exudates and Transudates; D006801:Humans; D008208:Lymphatic System / Q000378:metabolism*; D008875:Middle Aged; D009297:Nasal Mucosa / Q000378:metabolism*; D011183:Postoperative Complications / Q000175:diagnosis*; D011446:Prospective Studies; D012852:Sinusitis / Q000601:surgery*; D014168:Transferrin / Q000378:metabolism*
D014168:Transferrin