Liu Hai-Sheng, Liang Hui, Wang Dong, Wang Yan, Zheng Jia-Ping, Wang Yun-Peng, Chen Ye-Tao, Wang Shi-Jie, Chen Guo-Qiang, Zuo Huan-Cong
Department of Neurosurgery, Yuquan Hospital, Tsinghua University, Beijing 100049, China.
Zhonghua Yi Xue Za Zhi. 2009 Jan 6;89(1):63-5.
To investigate the effects of topical fluorescein on the preoperative diagnosis of rhinorrhea of cerebrospinal fluid (CSF) and intraoperative localization of CSF fistula.
Cotton pads soaked with 5% fluorescein were placed in the middle turbinate meatus, roof of ethmoid plate, and sphenoethmoidalis recesses via endoscopic endonasal technique of 15 patients with CSF rhinorrhea, 5 caused by accidental trauma and 10 spontaneous. Change of the color of fluorescein from yellow to green fluorescence denoted the presence of CSF, and thus the site of the leak could be traced. The accuracy rates of diagnosis and leak site identification by this technique were compared with those by glucose analysis, intraoperative findings, and follow-up.
The preoperative diagnosis rate of CSF rhinorrhea and the CSF fistula site localization rate by fluorescein-soaked cotton pad were both 100%. No recurrence was found during the follow-up for 2 - 24 months. No complication had been reported.
Application of topical fluorescein is an easy, sensitive, safe, and highly accurate tool in the intraoperative localization of the site and extent of CSF fistulas and should be considered a viable noninvasive alternative to intrathecal fluorescein technique.
探讨局部应用荧光素对脑脊液鼻漏术前诊断及术中脑脊液瘘定位的效果。
通过鼻内镜下经鼻技术，将浸有5%荧光素的棉片置于15例脑脊液鼻漏患者的中鼻道、筛骨板顶部和蝶筛隐窝，其中5例由意外创伤引起，10例为自发性脑脊液鼻漏。荧光素颜色由黄色变为绿色荧光表明存在脑脊液，从而可追踪漏口部位。将该技术诊断及漏口部位识别的准确率与葡萄糖分析、术中发现及随访结果进行比较。
浸有荧光素的棉片对脑脊液鼻漏的术前诊断率及脑脊液瘘口定位率均为100%。在2至24个月的随访期间未发现复发。未报告并发症。
局部应用荧光素是术中定位脑脊液瘘口部位及范围的一种简便、敏感、安全且高度准确的工具，应被视为鞘内注射荧光素技术可行的非侵入性替代方法。
