Meco Cem, Arrer Erich, Oberascher Gerhard
Department of Otorhinolaryngology- Head and Neck Surgery, Salzburg Paracelsus University Medical School, Salzburg, Austria.
Am J Rhinol. 2007 Nov-Dec;21(6):729-36. doi: 10.2500/ajr.2007.21.3105.
After cerebrospinal fluid (CSF) fistula repair, the goal of watertight sealing may not always be achieved, causing postoperative CSF leakage. The aim of this study was to assess the novel application of the beta-trace protein (betaTP) test for postoperative screening and confirmation of dura repair success.
Prospectively, we investigated 32 consecutive patients who underwent dura repair. Postoperative nasal secretion and serum were analyzed for CSF marker betaTP, to detect or rule out postoperative CSF leakage.
In 29 patients no CSF was detected, indicating 91% dura repair success after the first step. Three patients required additional surgery, verifying CSF leak. Additional betaTP testing was negative, revealing successful dura repair.
Dura repairs should be controlled for the presence or absence of postoperative CSF leakage. In our hands, the sensitive, fast, and inexpensive betaTP test has shown its value as an effective postoperative screening tool for dura repair success confirmation. Therefore, we consider it as novel "standard of care" and reserve invasive, more expensive or time-consuming methods as second choice.
脑脊液（CSF）瘘修补术后，实现水密密封的目标并非总能达成，从而导致术后脑脊液漏。本研究的目的是评估β-微量蛋白（betaTP）检测在术后筛查及确认硬脑膜修补成功方面的新应用。
我们前瞻性地研究了32例连续接受硬脑膜修补的患者。对术后鼻腔分泌物和血清进行脑脊液标志物betaTP分析，以检测或排除术后脑脊液漏。
29例患者未检测到脑脊液，表明第一步硬脑膜修补成功率为91%。3例患者需要额外手术，证实存在脑脊液漏。额外的betaTP检测为阴性，表明硬脑膜修补成功。
应检查硬脑膜修补术后是否存在脑脊液漏。在我们的研究中，敏感、快速且廉价的betaTP检测已显示出其作为确认硬脑膜修补成功的有效术后筛查工具的价值。因此，我们将其视为新的“护理标准”，而将侵入性更强、更昂贵或更耗时的方法作为第二选择。
