[Cerebrospinal otorrhea--cerebrospinal rhinorrhea. The Salzburg concept of cerebrospinal fluid diagnosis].

The three following cerebrospinal fluid (CSF) examinations make it possible to identify even the smallest amounts of CSF in case of CSF otorrhoea and rhinorrhoea. 1. Immunological identification of beta 2-transferrin (Oberascher/Arrer) 2. Laboratory fluorescein identification (Oberascher/Arrer) 3. Endoscopic fluorescein detection according to Messerklinger. For screening, and as the method of choice, beta 2-transferrin identification is always used as a first step if there is a suspicion of liquorrhoea. Depending on the result and on further measures, both fluorescein tests are used additionally in diagnosis. Basing on practical experience gained recently, special attention is given to test analysis, the various possibilities of taking samples, and their means of transport or mailing. A newly developed diagnostic step-by-step plan is intended to emphasise the clinical significance by means of practical examples. This concept represents the present state of the art in CSF diagnosis and demonstrates that a much mor precise range of indication is possible in surgery of fractures of the base of the skull and CSF leaks if it is combined with an appropriate x-ray examination.