Is topical fluorescein that effective in endoscopic CSF leak closure?

Erdem Eren, Gönül Güvenç, Akif İşlek, Seçil Arslanoğlu, Kazım Önal, Nurullah Yüceer

European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery 2020 Apr

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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. 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. 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. If radiologic studies fail to locate the defect properly, topical fluorescein only confirms the CSF leak, but the defect cannot be located anatomically intraoperatively.

Citation

Erdem Eren, Gönül Güvenç, Akif İşlek, Seçil Arslanoğlu, Kazım Önal, Nurullah Yüceer. Is topical fluorescein that effective in endoscopic CSF leak closure? European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. 2020 Apr;277(4):1073-1077