Topical intranasal fluorescein to localize a cerebrospinal fluid leak: A demonstration

Topical intranasal fluorescein to localize a cerebrospinal fluid leak: A demonstration:



Publication date: Available online 11 February 2020

Source: American Journal of Otolaryngology

Author(s): Jeremy Barr, Jason Ni, Johnathan McGinn, Neerav Goyal

Abstract

Background

Intrathecal fluorescein is commonly used to localize cerebrospinal fluid leaks. This technique is invasive and associated with several potential adverse effects. The purpose of this video presentation is to demonstrate an alternative technique, the intranasal use of dilute topical fluorescein, to localize a cerebrospinal fluid leak intraoperatively.

Methods

A 45-year-old male with a history of benign intracranial hypertension and 2 months of right-sided rhinorrhea underwent surgical repair of a cerebrospinal fluid leak. Topical fluorescein was applied intraoperatively to localize the defect.

Results

At 1- and 3-month follow-ups the patient was without cerebrospinal fluid rhinorrhea and the middle turbinate flap was intact.

Conclusion

Topical application of dilute intranasal fluorescein is a feasible and efficient tool for localizing cerebrospinal fluid leaks.