Tuesday, February 16, 2021

Is topical fluorescein that effective in endoscopic CSF leak closure?

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Is topical fluorescein that effective in endoscopic CSF leak closure?

Eur Arch Otorhinolaryngol. 2020 Apr;277(4):1073-1077

Authors: Eren E, Güvenç G, İşlek A, Arslanoğlu S, Önal K, Yüceer N

Abstract
PURPOSE: Several diagnostic modalities are used to detect CSF leaks. Intraoperative use of intrathecal fluorescein can help to detect and localize a CSF leak simultaneously. However, it is not FDA approved, the application is invasive and has serious complications. Topical fluorescein is reported to be a safe and sensitive alternative to ITF. In this study, we aimed to evaluate the effectiveness of topical fluorescein in CSF leak closure.
METHODS: This retrospective study includes 27 consecutive patients (19 women, 8 men) who underwent endoscopic endonasal CSF leak closure using topical fluorescein, between 2011 and 2017.
RESULTS: In two patients, radiologic studies false positively locate the defect. β2 transferrin and topical fluorescein tests were positive in these patients. Both cases needed a second operation.
CONCLUSION: If radiologic studies fail to locate the defect properly, topical fluorescein only confirms the CSF leak, but the defect cannot be located anatomically intraoperatively.

PMID: 31845038 [PubMed - in process]

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