Incidence of CSF fistula after paranasal sinus surgery: the Northern Norwegian experience.

STATEMENT OF PROBLEM

Cerebrospinal fluid (CSF) fistula is a well-known complication of paranasal sinus surgery. Not only manifest, but also occult CSF fistulas occur. The incidence of occult CSF fistula has been described only once and has not been tested since.

MATERIAL AND METHODS

In a prospective diagnostic study, the incidence of manifest and occult CSF fistulas was measured. Forty four patients operated for paranasal sinus diseases were included between 2002 and 2006. Seventy four fluid samples were collected by pressing nasal tamponades the day after surgery, and were measured for beta-trace protein using laser-nephelometry. In patients with a beta-trace value in secretion between 0.68 and 1.11 mg/l, a serum sample was taken and measured for beta-trace protein.

RESULTS

Thirty-one patients had a secretion beta-trace protein value below 0.68 mg/l. Thirteen patients had a secretion beta-trace protein value between 0.68 and 1.11 mg/l. The secretion/serum ratio in this group was below 1.57, not indicating the presence of CSF traces. The incidence of CSF fistula in this study population was zero.

PRINCIPAL CONCLUSION

A previously described incidence of occult CSF fistula after paranasal sinus surgery was not confirmed in the present study.