Intrathecal fluorescein in endoscopic skull base surgery.
作者信息
Tabaee Abtin, Placantonakis Dimitris G, Schwartz Theodore H, Anand Vijay K
机构信息
Department of Otolaryngology--Head and Neck Surgery, Weill Medical College of Cornell University, New York Presbyterian Hospital, New York, NY 10002, USA.
出版信息
Otolaryngol Head Neck Surg. 2007 Aug;137(2):316-20. doi: 10.1016/j.otohns.2006.11.012.
OBJECTIVES
Reconstruction following endoscopic skull base surgery requires a high degree of success to avoid the morbidity of postoperative cerebrospinal fluid (CSF) leak. The impact on outcomes of CSF visualization with intrathecal fluorescein, however, is unknown.
STUDY DESIGN
A retrospective review of patients undergoing endoscopic skull base surgery with intrathecal fluorescein. A possible correlation between intraoperative fluorescein identification and postoperative CSF leak was analyzed.
RESULTS
61 patients underwent surgery for a variety of lesions including pituitary adenoma (55.7%), encephalocele (14.8%), and meningioma (9.8%). Seven (19.4%) of the 37 patients with intraoperative fluorescein leak experienced postoperative CSF leak compared to 0 of the 24 patients who did not have intraoperative fluorescein leak (P = 0.02). All cases of CSF leak resolved with lumbar drainage alone.
CONCLUSIONS
The lack of intraoperative fluorescein leakage correlates strongly with a low risk for postoperative CSF leak. This can be used to stratify the extent of skull base reconstruction required during endoscopic skull base surgeries.
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