Endoscopic repair of cerebrospinal fluid rhinorrhea.
BACKGROUND
Nasal liquorrhea indicates a cerebrospinal fluid fistula, an open communication between the intracranial cerebrospinal fluid and the nasal cavity. It can be traumatic and spontaneous.


OBJECTIVE
The aim of this study was to assess the outcome of endoscopic repair of cerebrospinal fluid fistula using fluorescein.


METHODS
This retrospective study included 30 patients of both sexes, with a mean age of 48.7 years, treated in the period from 2007 to 2015. All patients underwent lumbar administration of 5% sodium fluorescein solution preoperatively. Fistula was closed using three-layer graft and fibrin glue.


RESULTS
Cerebrospinal fluid fistulas were commonly located in the ethmoid (37%) and sphenoid sinus (33%). Most patients presented with traumatic cerebrospinal fluid fistulas (2/3 of patients). The reported success rate for the first repair attempt was 97%. Complications occurred in three patients: one patient presented with acute hydrocephalus, one with reversible encephalopathy syndrome on the fifth postoperative day with bilateral loss of vision, and one patient was diagnosed with hydrocephalus two years after the repair of cerebrospinal fluid fistula.


CONCLUSIONS
Endoscopic diagnosis and repair of cerebrospinal fluid fistulas using fluorescein intrathecally has high success rate and low complication rate.
University of Novi Sad, Faculty of Medicine, Hajduk Veljkova, Novi Sad, Serbia; Clinical Center of Vojvodina, ENT Clinic, Hajduk Veljkova, Novi Sad, Serbia.
Vladimir
V
Kljajić
University of Novi Sad, Faculty of Medicine, Hajduk Veljkova, Novi Sad, Serbia; Clinical Center of Vojvodina, Clinic of Neurosurgery, Hajduk Veljkova, Novi Sad, Serbia.
Petar
P
Vuleković
University of Novi Sad, Faculty of Medicine, Hajduk Veljkova, Novi Sad, Serbia; Clinical Center of Vojvodina, ENT Clinic, Hajduk Veljkova, Novi Sad, Serbia.
Ljiljana
L
Vlaški
University of Novi Sad, Faculty of Medicine, Hajduk Veljkova, Novi Sad, Serbia; Clinical Center of Vojvodina, ENT Clinic, Hajduk Veljkova, Novi Sad, Serbia.
Slobodan
S
Savović
University of Novi Sad, Faculty of Medicine, Hajduk Veljkova, Novi Sad, Serbia; Clinical Center of Vojvodina, ENT Clinic, Hajduk Veljkova, Novi Sad, Serbia. Electronic address: danijela.dragicevic@mf.uns.ac.rs.
Danijela
D
Dragičević
University of Novi Sad, Faculty of Medicine, Hajduk Veljkova, Novi Sad, Serbia; Clinical Center of Vojvodina, Clinic of Neurosurgery, Hajduk Veljkova, Novi Sad, Serbia.
Vladimir
V
Papić
D000328:Adult; D000368:Aged; D002559:Cerebrospinal Fluid Rhinorrhea / Q000601:surgery*; D005260:Female; D005452:Fluoresceins; D006801:Humans; D008297:Male; D008875:Middle Aged; D044583:Neuroendoscopy / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
D005452:Fluoresceins
Cerebrospinal fluid rhinorrhea; Desfecho do tratamento; Endoscopia; Endoscopy; Fistula; Fluorescein; Fluoresceína; Fístula; Nasal surgical procedures; Procedimentos cirúrgicos nasais; Rinorreia de líquido cerebrospinal; Treatment outcome