TY - JOUR ID - 88281 TI - Preoperative Topical Intranasal Fluorescein in Diagnosis of Cerebrospinal Fluid Rhinorrhea JO - Archives of Trauma Research JA - ATR LA - en SN - 2251-953X AU - Hashemi Jazi, Seyed Mostafa AU - Amini, Zhale AU - Saboori, Masih AU - Raisi, Mostafa AD - Department of Otolaryngology, Isfahan University of Medical Sciences, Isfahan, Iran AD - Department of Neurosurgery, Isfahan University of Medical Sciences, Isfahan, Iran AD - Department of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Y1 - 2018 PY - 2018 VL - 7 IS - 4 SP - 146 EP - 149 KW - cerebrospinal fluid KW - endoscope KW - fluorescein KW - Intrathecal KW - rhinorrhea KW - skull base KW - Topical DO - 10.4103/atr.atr_87_18 N2 - Background and Objectives: The preoperative diagnosis of cerebrospinal fluid (CSF) leak site is necessary for the management of CSF rhinorrhea. At present, intrathecal fluorescein is a common approach for it; however, regarding drawbacks, its value is limited. This study aimed at examining the effects of topical intranasal fluorescein (TINF) on the preoperative diagnosis of CSF rhinorrhea and intraoperative localization of CSF fistula. Patients and Methods: In this cross‑sectional study, 32 consecutive patients with CSF rhinorrhea were recruited. Topical intranasal 10% fluorescein was placed in common sites of leakage, the middle turbinate meatus, the roof of the ethmoid plate, and sphenoethmoidal recesses. Change of the color of fluorescein indicated the presence of CSF, and thus, the site of the fistula could be outlined. The accuracy rates of diagnosis of leak site identified by TINF were compared with those by available imaging modalities, CSF analysis, intraoperative findings, and follow‑up. Results: The cause of the leak was traumatic in 22 patients and nontraumatic in 10 patients. Preoperative accuracy rate of the location of CSF fistula was estimated 58.3% by available imaging study. The preoperative diagnosis rate of CSF rhinorrhea and the CSF fistula site localization rate by TINF were both 100%. No recurrence was found during the follow‑up for 2–12 months. No complication had been reported. Conclusions: Preoperative TINF is an easy, quick, sensitive, safe, and accurate tool in localization of the site of the CSF fistulas and can be considered as a viable noninvasive alternative to the intrathecal fluorescein technique for preoperative diagnosis of CSF rhinorrhea. UR - https://archtrauma.kaums.ac.ir/article_88281.html L1 - https://archtrauma.kaums.ac.ir/article_88281_f70ea009ff0d1fe6488d60c7e12430c5.pdf ER -