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Updated: Jan 1, 2026
Intrathecal Application of a Fluorescent Dye for the Identification of Cerebrospinal Fluid Leaks in Cochlear Malformation
Published on: February 29, 2020
Is topical fluorescein that effective in endoscopic CSF leak closure?
Erdem Eren1, Gönül Güvenç2, Akif İşlek3
1Department of Otolaryngology Head and Neck Surgery, İzmir Atatürk Research and Education Hospital, Basın sitesi Mh. Hasan Tahsin Cd., No: 143, Karabaglar, İzmir, Turkey. erd2eren@yahoo.com.
Purpose:
Several diagnostic modalities are used to detect CSF leaks. Intraoperative use of intrathecal fluorescein can help to detect and localize a CSF leak simultaneously. However, it is not FDA approved, the application is invasive and has serious complications. Topical fluorescein is reported to be a safe and sensitive alternative to ITF. In this study, we aimed to evaluate the effectiveness of topical fluorescein in CSF leak closure.
Methods:
This retrospective study includes 27 consecutive patients (19 women, 8 men) who underwent endoscopic endonasal CSF leak closure using topical fluorescein, between 2011 and 2017.
Results:
In two patients, radiologic studies false positively locate the defect. β2 transferrin and topical fluorescein tests were positive in these patients. Both cases needed a second operation.
Conclusion:
If radiologic studies fail to locate the defect properly, topical fluorescein only confirms the CSF leak, but the defect cannot be located anatomically intraoperatively.
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