Is topical fluorescein that effective in endoscopic CSF leak closure?
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...
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| Veröffentlicht in: | European archives of oto-rhino-laryngology 2020-04, Vol.277 (4), p.1073-1077 |
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| container_title | European archives of oto-rhino-laryngology |
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| creator | Eren, Erdem Güvenç, Gönül İşlek, Akif Arslanoğlu, Seçil Önal, Kazım Yüceer, Nurullah |
| description | 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. |
| doi_str_mv | 10.1007/s00405-019-05766-1 |
| format | Article |
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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.
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.</description><identifier>ISSN: 0937-4477</identifier><identifier>EISSN: 1434-4726</identifier><identifier>DOI: 10.1007/s00405-019-05766-1</identifier><identifier>PMID: 31845038</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Cerebrospinal Fluid Leak - diagnosis ; Cerebrospinal Fluid Leak - etiology ; Cerebrospinal Fluid Rhinorrhea - diagnosis ; Cerebrospinal Fluid Rhinorrhea - etiology ; Cerebrospinal Fluid Rhinorrhea - surgery ; Contrast Media - administration & dosage ; Endoscopy ; Female ; Fluorescein - administration & dosage ; Head and Neck Surgery ; Humans ; Male ; Medicine ; Medicine & Public Health ; Neurosurgery ; Otorhinolaryngology ; Retrospective Studies ; Rhinology</subject><ispartof>European archives of oto-rhino-laryngology, 2020-04, Vol.277 (4), p.1073-1077</ispartof><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2019</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c347t-8609d31dd8e5713d49733d10b971806b5144996a566a2922ab8a3efcd25f4e893</citedby><cites>FETCH-LOGICAL-c347t-8609d31dd8e5713d49733d10b971806b5144996a566a2922ab8a3efcd25f4e893</cites><orcidid>0000-0003-4475-3250</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00405-019-05766-1$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00405-019-05766-1$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31845038$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Eren, Erdem</creatorcontrib><creatorcontrib>Güvenç, Gönül</creatorcontrib><creatorcontrib>İşlek, Akif</creatorcontrib><creatorcontrib>Arslanoğlu, Seçil</creatorcontrib><creatorcontrib>Önal, Kazım</creatorcontrib><creatorcontrib>Yüceer, Nurullah</creatorcontrib><title>Is topical fluorescein that effective in endoscopic CSF leak closure?</title><title>European archives of oto-rhino-laryngology</title><addtitle>Eur Arch Otorhinolaryngol</addtitle><addtitle>Eur Arch Otorhinolaryngol</addtitle><description>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.</description><subject>Cerebrospinal Fluid Leak - diagnosis</subject><subject>Cerebrospinal Fluid Leak - etiology</subject><subject>Cerebrospinal Fluid Rhinorrhea - diagnosis</subject><subject>Cerebrospinal Fluid Rhinorrhea - etiology</subject><subject>Cerebrospinal Fluid Rhinorrhea - surgery</subject><subject>Contrast Media - administration & dosage</subject><subject>Endoscopy</subject><subject>Female</subject><subject>Fluorescein - administration & dosage</subject><subject>Head and Neck Surgery</subject><subject>Humans</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neurosurgery</subject><subject>Otorhinolaryngology</subject><subject>Retrospective Studies</subject><subject>Rhinology</subject><issn>0937-4477</issn><issn>1434-4726</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1Lw0AQhhdRbK3-AQ-So5fV2ez3SaS0KhQ8qOdlk0w0NU3qbiL4701N9ehpYOaZl5mHkHMGVwxAX0cAAZICsxSkVoqyAzJlggsqdKoOyRQs11QIrSfkJMY1AEhh-TGZcGaEBG6mZPEQk67dVrmvk7Lu24Axx6pJujffJViWmHfVJyZDB5uijfkOTeZPy6RG_57kdRv7gDen5Kj0dcSzfZ2Rl-XieX5PV493D_PbFc250B01CmzBWVEYlJrxQljNecEgs5oZUJlkQlirvFTKpzZNfWY8xzIvUlkKNJbPyOWYuw3tR4-xc5tquLeufYNtH13KU225MdoMaDqieWhjDFi6bag2Pnw5Bm6nz4363KDP_ehzbFi62Of32QaLv5VfXwPARyAOo-YVg1u3fWiGn_-L_QZrOXkp</recordid><startdate>20200401</startdate><enddate>20200401</enddate><creator>Eren, Erdem</creator><creator>Güvenç, Gönül</creator><creator>İşlek, Akif</creator><creator>Arslanoğlu, Seçil</creator><creator>Önal, Kazım</creator><creator>Yüceer, Nurullah</creator><general>Springer Berlin Heidelberg</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-4475-3250</orcidid></search><sort><creationdate>20200401</creationdate><title>Is topical fluorescein that effective in endoscopic CSF leak closure?</title><author>Eren, Erdem ; Güvenç, Gönül ; İşlek, Akif ; Arslanoğlu, Seçil ; Önal, Kazım ; Yüceer, Nurullah</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c347t-8609d31dd8e5713d49733d10b971806b5144996a566a2922ab8a3efcd25f4e893</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Cerebrospinal Fluid Leak - diagnosis</topic><topic>Cerebrospinal Fluid Leak - etiology</topic><topic>Cerebrospinal Fluid Rhinorrhea - diagnosis</topic><topic>Cerebrospinal Fluid Rhinorrhea - etiology</topic><topic>Cerebrospinal Fluid Rhinorrhea - surgery</topic><topic>Contrast Media - administration & dosage</topic><topic>Endoscopy</topic><topic>Female</topic><topic>Fluorescein - administration & dosage</topic><topic>Head and Neck Surgery</topic><topic>Humans</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Neurosurgery</topic><topic>Otorhinolaryngology</topic><topic>Retrospective Studies</topic><topic>Rhinology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Eren, Erdem</creatorcontrib><creatorcontrib>Güvenç, Gönül</creatorcontrib><creatorcontrib>İşlek, Akif</creatorcontrib><creatorcontrib>Arslanoğlu, Seçil</creatorcontrib><creatorcontrib>Önal, Kazım</creatorcontrib><creatorcontrib>Yüceer, Nurullah</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European archives of oto-rhino-laryngology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Eren, Erdem</au><au>Güvenç, Gönül</au><au>İşlek, Akif</au><au>Arslanoğlu, Seçil</au><au>Önal, Kazım</au><au>Yüceer, Nurullah</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Is topical fluorescein that effective in endoscopic CSF leak closure?</atitle><jtitle>European archives of oto-rhino-laryngology</jtitle><stitle>Eur Arch Otorhinolaryngol</stitle><addtitle>Eur Arch Otorhinolaryngol</addtitle><date>2020-04-01</date><risdate>2020</risdate><volume>277</volume><issue>4</issue><spage>1073</spage><epage>1077</epage><pages>1073-1077</pages><issn>0937-4477</issn><eissn>1434-4726</eissn><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.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>31845038</pmid><doi>10.1007/s00405-019-05766-1</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0003-4475-3250</orcidid></addata></record> |
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| source | MEDLINE; SpringerLink Journals |
| subjects | Cerebrospinal Fluid Leak - diagnosis Cerebrospinal Fluid Leak - etiology Cerebrospinal Fluid Rhinorrhea - diagnosis Cerebrospinal Fluid Rhinorrhea - etiology Cerebrospinal Fluid Rhinorrhea - surgery Contrast Media - administration & dosage Endoscopy Female Fluorescein - administration & dosage Head and Neck Surgery Humans Male Medicine Medicine & Public Health Neurosurgery Otorhinolaryngology Retrospective Studies Rhinology |
| title | Is topical fluorescein that effective in endoscopic CSF leak closure? |
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