Use of a hypodense sodium fluorescein solution for the endoscopic repair of rhinogenic cerebrospinal fluid fistulae.
BACKGROUND
Hypodense fluorescein solution can be used intrathecally to facilitate and accelerate the identification of the fistulous site.


METHODS
Eighteen patients were submitted for nasal endoscopic correction of rhinogenic cerebrospinal fluid fistulas after their identification with a hypodense sodium fluorescein solution.


RESULTS
Intrathecal injection of hypodense fluorescein permitted a rapid and safe identification of the leak and did not present significant side effects. The fistulous site was identified in all patients, and the time needed for staining was <30 minutes in all cases. Surgery was successful in 88% of the patients after only one intervention, with the rate reaching 100% after a secondary intervention in cases of recurrence.


CONCLUSIONS
Intrathecal injection of a hypodense sodium fluorescein solution permits a more precise, rapid, and safe endoscopic approach, with no need to place the patient in the Trendelenburg position or to wait for a long period of time before starting the surgical procedure.
Demarco
Ricardo Cassiano
RC
Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Faculty of Medicine of Ribeirão Preto, Ribeirão Preto, Brazil.
Tamashiro
Edwin
E
Valera
Fabiana Cardoso Pereira
FC
Anselmo-Lima
Wilma T
WT
D000293:Adolescent; D000328:Adult; D000368:Aged; D002559:Cerebrospinal Fluid Rhinorrhea / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D004724:Endoscopy / Q000379:methods*; D005004:Ethmoid Bone / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D005402:Fistula / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D005452:Fluoresceins; D005456:Fluorescent Dyes; D006801:Humans; D007278:Injections, Spinal; D008297:Male; D008875:Middle Aged; D010254:Paranasal Sinus Diseases / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D012189:Retrospective Studies; D012996:Solutions; D014057:Tomography, X-Ray Computed
D005452:Fluoresceins; D005456:Fluorescent Dyes; D012996:Solutions