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International Bulletin of Otorhinolaryngology

Cerebrospinal Fluid Rhinorrhea – Diagnostic Metodes Review and Clinical Cases Demonstration

K. Dzhambazov, S. Markov, A. Topalova

Abstract

Introduction: Cerebrospinal fluid rhinorrhea means a cerebrospinal fluid leakage from subarachnoid space into paranasal sinuses and from there into the nasal cavity. The exact localization of the rhinobasis defect causing cerebrospinal leak is always a serious problem and the exact choice of the diagnostic method lays in the base of the surgical success.
Aim: Using our experience and literature data, to review cerebrospinal fluid rhinorrhea diagnostic methods and their practical importance.
Material and methods: For the period 2000 - 2015 year in the ENT department of UMHAT Plovdiv 18 cerebrospinal fluid rhinorrhea cases have been diagnosed. Most of them were spontaneous or caused by neoplasm development. The correlation men to women was 5:13. In all cases several diagnostic methods were used – glucose oxidase test, high-resolution computed tomography (CT), in one case intrathecal fluorescein was used followed by endoscopic endonasal verification. Four of all 18 cerebrospinal fluid rhinorrhea cases arise with symptoms of rhinogenic meningitis. All patients underwent endonasal surgical treatment – dura matter closure.
Results: In 14 cases there was successful dura matter closure after the first surgery. No fluid leakage was detected. The endoscopic exam showed definitely closure of the defect. As for the rest cases, in 3 of them the cerebrospinal fluid rhinorrhea persisted postoperatively and in one case there was recurrence after one year. After another endoscopic surgery an definite leakage stop was achieved in all cases.
Conclusions: Modern diagnostic tests and endoscopic endonasal methods for closure with alogenic material permit relatively sure prove and localization of the rhinobasis defects and its definitive treatment, with low mortality and complications rate.

Keywords

Cerebrospinal fluid rhinorrhea, fistula cerebroslinalis, endonasal surgery, intratecal fluorescein. administration

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References

Cerebrospinal Fluid Rhinorrhea: Diagnosis and Management. Julie T. kerr, MD, Felix W.K. Chu, MD, Stephen W Bayles, MD

Imaging of Cerebrospinal Fluid Leaks. Erich Hofmann, Robert Behr, Konrad Schwager.

Endoscopic paranasal sinus surgery. Dale H.Rice, Steven D.Schaefer

Status Epilepticus and Intrathecal Fluorescein: Anesthesia Providers Beware. Adam K Jacob, MD, John A. Dilger, MD, James R. Hebl, MD

The Use of Low-Dose Intrathecal Fluorescein in Endoscopic Repair of Cerebrospinal Fluid Rhinorrhea. Seyed Amir Hossein Javadi, MD, Hadi Samimi MD, Fereshteh Naderi, MD, Mohammad Shirani, MD

CSF rhinorrhea: An overview of endoscopic repair. DP Sharma M Ch, D Singh M Ch, S. Sinha M Ch, AK Srivastva M Ch, H Singh M Ch, A Jagetia M Ch, Monica Tandon MD, P Ganjoo MD

Spectrum of complications in the use of intrathecal fluorescein. John I Moseley, M.S. M.D., Charles A. Carton M.D., W. Eugene Stern M.D.

Use of Sodium Fluorescein Solution for Detection of Cerebrospinal Fluid Fistulas: An Analysis of 420 Administrations and Reported Complications in Europe and the United States. Reiner Keerl, MD, Reiner Weber, MD, Wolfgang Draf, MD, FRCS Ed, A Wienke, Steven D. Schaefer, MD.

Use of a hypodense sodium fluorescein solution for the endoscopic repair of rhinogenic cerebrospinal fluid fistulae. Ricardo Cassiano Demarco, M.D., Edwin Tamashiro, M.D., Fabiana Cardoso Pereira Valera and Wilma T. Anselmo-Lima M.D., Ph.D.

Radiology: Imaging of Skull Base Cerebrospinal Fluid Leaks Adults – Kristen M. Lloyd MD, John M. Del Gaudio MD, Patricia A. Hudgins MD

Transnasal endoscopic repair of cerebrospinal fluid rhinorrhea: a meta-analysis. Hegazy HM, Carrau RL, Snyderman CH, Kassam, Zweig J.

Beta 2 transferrin and cerebrospinal fluid rhinorrhea Nandapalan V, Watson ID, Swift AC., Clin Otolaryngol 1996

Cerebrospinal fluid rhinorrhea: diagnosis and management, Abubabara A., Med Oral Patol Cir Bucal 2007

Low-dose intrathecal fluorescein and etiology-based graft choice in endoscopic endonasal closure of CSF leaks, Matei A. Banu, Joon – Hyung Kim, Bendjamin J. Shin, Vijay K. Anand, Department of Neurological surgery and Department of Otolaryngology, Weil Corneil Medical college, New York, USA




DOI: http://dx.doi.org/10.14748/orl.v11i3.6859

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