[Application of topical intranasal fluorescein in endoscopic endonasal repair of cerebrospinal fluid leakage].
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.
Liu
Hai-Sheng
HS
Department of Neurosurgery, Yuquan Hospital, Tsinghua University, Beijing 100049, China.
Liang
Hui
H
Wang
Dong
D
Wang
Yan
Y
Zheng
Jia-Ping
JP
Wang
Yun-Peng
YP
Chen
Ye-Tao
YT
Wang
Shi-Jie
SJ
Chen
Guo-Qiang
GQ
Zuo
Huan-Cong
HC
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
D019793:Fluorescein