title: [Application of topical intranasal fluorescein in endoscopic endonasal repair of cerebrospinal fluid leakage].
abstract: OBJECTIVE
  To investigate the effects of topical fluorescein on the preoperative diagnosis of rhinorrhea of cerebrospinal fluid (CSF) and intraoperative localization of CSF fistula.
  
  
  METHODS
  Cotton pads soaked with 5% fluorescein were placed in the middle turbinate meatus, roof of ethmoid plate, and sphenoethmoidalis recesses via endoscopic endonasal technique of 15 patients with CSF rhinorrhea, 5 caused by accidental trauma and 10 spontaneous. Change of the color of fluorescein from yellow to green fluorescence denoted the presence of CSF, and thus the site of the leak could be traced. The accuracy rates of diagnosis and leak site identification by this technique were compared with those by glucose analysis, intraoperative findings, and follow-up.
  
  
  RESULTS
  The preoperative diagnosis rate of CSF rhinorrhea and the CSF fistula site localization rate by fluorescein-soaked cotton pad were both 100%. No recurrence was found during the follow-up for 2 - 24 months. No complication had been reported.
  
  
  CONCLUSIONS
  Application of topical fluorescein is an easy, sensitive, safe, and highly accurate tool in the intraoperative localization of the site and extent of CSF fistulas and should be considered a viable noninvasive alternative to intrathecal fluorescein technique.
authors.affiliation: Department of Neurosurgery, Yuquan Hospital, Tsinghua University, Beijing 100049, China.
authors.forename: Hai-Sheng
authors.initials: HS
authors.lastname: Liu
authors.forename: Hui
authors.initials: H
authors.lastname: Liang
authors.forename: Dong
authors.initials: D
authors.lastname: Wang
authors.forename: Yan
authors.initials: Y
authors.lastname: Wang
authors.forename: Jia-Ping
authors.initials: JP
authors.lastname: Zheng
authors.forename: Yun-Peng
authors.initials: YP
authors.lastname: Wang
authors.forename: Ye-Tao
authors.initials: YT
authors.lastname: Chen
authors.forename: Shi-Jie
authors.initials: SJ
authors.lastname: Wang
authors.forename: Guo-Qiang
authors.initials: GQ
authors.lastname: Chen
authors.forename: Huan-Cong
authors.initials: HC
authors.lastname: Zuo
mesh_terms: D000281:Administration, Intranasal; D000328:Adult; D002559:Cerebrospinal Fluid Rhinorrhea / Q000601:surgery*; D004724:Endoscopy / Q000379:methods*; D005260:Female; D019793:Fluorescein / Q000008:administration & dosage*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged
chemical_list: D019793:Fluorescein