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Updated: Jul 7, 2026
06:59
Intrathecal Application of a Fluorescent Dye for the Identification of Cerebrospinal Fluid Leaks in Cochlear Malformation
Published on: February 29, 2020
[Fluorescence of the middle ear]
D Kleemann1, S Nofz, A Schlottmann
1Klinik für Hals-, Nasen- und Ohrenheilkunde, Müritz-Klinikum GmbH der MediClin AG, Weinbergstrasse 19, 17192, Waren, Deutschland. kleemann-waren@t-online.de
HNO
|February 6, 2008
Summary
Fluorescence endoscopy of the middle ear can detect fluorescein in perilymph, aiding diagnosis of inner ear fluid leakage. Optimal timing, 45 minutes to 2 hours post-injection, is key for accurate results.
Area of Science:
- Otolaryngology
- Medical Imaging
- Fluorescence Diagnostics
Background:
- Contradictory findings exist regarding fluorescein detection in perilymph after intravenous administration.
- Distinguishing mucosal fluorescence from extravasation or perilymph fistula signals is challenging.
Purpose of the Study:
- To evaluate the utility of fluorescence endoscopy for detecting fluorescein in the middle ear.
- To establish optimal timing for fluorescence endoscopy after intravenous fluorescein administration.
Main Methods:
- Fluorescence endoscopy was performed on 53 patients with cochleovestibular disturbances after intravenous fluorescein administration.
- Endoscopic signs were documented in 40 patients, with some receiving intrathecal fluorescein or undergoing surgery.
Main Results:
- Fluorescence was detected on the eardrum within 15-20 seconds of IV fluorescein injection.
- Middle ear mucosa fluorescence peaked around 4 minutes, with longer duration in inflamed ears.
- Fluid in the round or oval niche was observed in 25 patients, with samples showing increased beta fraction.
Conclusions:
- Fluorescence endoscopy is a viable method for detecting fluorescein in the middle ear.
- The crucial time window for examination is 45 minutes to 2 hours post-intravenous fluorescein administration.
- This dynamic procedure aids in diagnosing inner ear conditions potentially related to fluid leakage.
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