Surgical occlusion of cerebrospinal fistulas of the anterior skull base using intrathecal sodium fluorescein

Laryngo- rhino- otologie
H StammbergerW Luxenberger

Abstract

For more than 25 years, intrathecal 5% sodium fluorescein has been routinely used at the University ENT Hospital at Graz during surgical closures of CSF leaks of the anterior skull base. Especially with endoscopic approaches, this technique has been of significant help in identifying and localizing dural defects. No fluorescein-related complications occurred in the series reported. In a retrospective study, indications, techniques, and results of surgical closures of CSF leaks of the anterior skull base are reviewed. During 5 1/2 years from 1990-1995, 72 patients with CSF-rhinorrhea were operated on at our department, 69 of whom had sodium fluorescein applied intrathecally. In 41 patients strictly endoscopic techniques were applied, in 22 patients an external approach was chosen and in 9 cases combined approaches were used. Defects in the roof of the ethmoid, the lamina cribrosa, and in the sphenoid sinus almost exclusively were approached endoscopically. Defects in the posterior table of the frontal sinus, especially when located laterally, were approached from externally or via combined endonasal and external routes. The causes of the CSF leaks, their localization, and the surgical approaches chosen are analysed and the surgi...Continue Reading

Citations

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