Intrathecal fluorescein in endoscopic skull base surgery.
OBJECTIVE
Reconstruction following endoscopic skull base surgery requires a high degree of success to avoid the morbidity of postoperative cerebrospinal fluid (CSF) leak. The impact on outcomes of CSF visualization with intrathecal fluorescein, however, is unknown.


METHODS
A retrospective review of patients undergoing endoscopic skull base surgery with intrathecal fluorescein. A possible correlation between intraoperative fluorescein identification and postoperative CSF leak was analyzed.


RESULTS
61 patients underwent surgery for a variety of lesions including pituitary adenoma (55.7%), encephalocele (14.8%), and meningioma (9.8%). Seven (19.4%) of the 37 patients with intraoperative fluorescein leak experienced postoperative CSF leak compared to 0 of the 24 patients who did not have intraoperative fluorescein leak (P = 0.02). All cases of CSF leak resolved with lumbar drainage alone.


CONCLUSIONS
The lack of intraoperative fluorescein leakage correlates strongly with a low risk for postoperative CSF leak. This can be used to stratify the extent of skull base reconstruction required during endoscopic skull base surgeries.
Department of Otolaryngology--Head and Neck Surgery, Weill Medical College of Cornell University, New York Presbyterian Hospital, New York, NY 10002, USA.
Abtin
A
Tabaee
Dimitris G
DG
Placantonakis
Theodore H
TH
Schwartz
Vijay K
VK
Anand
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002555:Cerebrospinal Fluid; D002648:Child; D003287:Contrast Media / Q000008:administration & dosage; D004724:Endoscopy; D005260:Female; D019793:Fluorescein; D006801:Humans; D015994:Incidence; D007278:Injections, Spinal; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D012307:Risk Factors; D019291:Skull Base / Q000601:surgery*
D003287:Contrast Media; D019793:Fluorescein