Intrathecal fluorescein in endoscopic skull base surgery

被引:71
作者
Tabaee, Abtin
Placantonakis, Dimitris G.
Schwartz, Theodore H.
Anand, Vijay K.
机构
[1] Cornell Univ, Weill Med coll, New York Presbyterian Hosp, Dept Otolaryngol Head & Neck Surg, Ithaca, NY 14853 USA
[2] Cornell Univ, Weill Med coll, New York Presbyterian Hosp, Dept Neurol Surg, Ithaca, NY 14853 USA
关键词
D O I
10.1016/j.otohns.2006.11.012
中图分类号
R76 [耳鼻咽喉科学];
学科分类号
100213 ;
摘要
OBJECTIVES: Reconstruction following endoscopic skull base surgery requires a high degree of success to avoid the morbidity of postoperative cerebrospinal fluid (CSF) leak. The impact on outcomes of CSF visualization with intrathecal fluorescein, however, is unknown. STUDY DESIGN: A retrospective review of patients undergoing endoscopic skull base surgery with intrathecal fluorescein. A possible correlation between intraoperative fluorescein identification and postoperative CSF leak was analyzed. RESULTS: 61 patients underwent surgery for a variety of lesions including pituitary adenoma (55.7%), encephalocele (14.8%), and meningioma (9.8%). Seven (19.4%) of the 37 patients with intraoperative fluorescein leak experienced postoperative CSF leak compared to 0 of the 24 patients who did not have intraoperative fluorescein leak (P = 0.02). All cases of CSF leak resolved with lumbar drainage alone. CONCLUSIONS: The lack of intraoperative fluorescein leakage correlates strongly with a low risk for postoperative CSF leak. This can be used to stratify the extent of skull base reconstruction required during endoscopic skull base surgeries. (c) 2007 American Academy of Otolaryngology-Head and Neck Surgery Foundation. All rights reserved.
引用
收藏
页码:316 / 320
页数:5
相关论文
共 19 条
[1]   Incidence of occult cerebrospinal fluid fistula during paranasal sinus surgery [J].
Bachmann, G ;
Djenabi, U ;
Jungehulsing, M ;
Petereit, H ;
Michel, O .
ARCHIVES OF OTOLARYNGOLOGY-HEAD & NECK SURGERY, 2002, 128 (11) :1299-1302
[2]   Endoscopic endonasal transsphenoidal surgery [J].
Cappabianca, P ;
Cavallo, LM ;
de Divitiis, E .
NEUROSURGERY, 2004, 55 (04) :933-940
[3]   Sellar repair with fibrin sealant and collagen fleece after endoscopic endonasal transsphenoidal surgery [J].
Cappabianca, P ;
Cavallo, LM ;
Valente, V ;
Romano, I ;
D'Enza, AI ;
Esposito, F ;
de Divitiis, E ;
Laws, ER .
SURGICAL NEUROLOGY, 2004, 62 (03) :227-233
[4]   Endoscopic endonasal transsphenoidal approach: Outcome analysis of 100 consecutive procedures [J].
Cappabianca, P ;
Cavallo, LM ;
Colao, A ;
De Caro, MDB ;
Esposito, F ;
Cirillo, S ;
Lombardi, G ;
Divitiis, E .
MINIMALLY INVASIVE NEUROSURGERY, 2002, 45 (04) :193-200
[5]   Sellar repair in endoscopic endonasal transsphenoidal surgery: Results of 170 cases [J].
Cappabianca, P ;
Cavallo, LM ;
Esposito, F ;
Valente, V ;
de Divitiis, E .
NEUROSURGERY, 2002, 51 (06) :1365-1371
[6]   Pituitary surgery [J].
Carrau, RL ;
Kassam, AB ;
Snyderman, CH .
OTOLARYNGOLOGIC CLINICS OF NORTH AMERICA, 2001, 34 (06) :1143-+
[7]   Endoscopic transsphenoidal approach: Adaptability of the procedure to different sellar lesions [J].
de Divitiis, E ;
Cappabianca, P ;
Cavallo, LM .
NEUROSURGERY, 2002, 51 (03) :699-705
[8]  
El-Banhawy OA, 2003, MINIM INVAS NEUROSUR, V46, P289
[9]   Endoscopic management of anterior skull base tumors [J].
Har-El, G ;
Casiano, RR .
OTOLARYNGOLOGIC CLINICS OF NORTH AMERICA, 2005, 38 (01) :133-+
[10]   Transnasal endoscopic repair of cerebrospinal fluid rhinorrhea: A meta-analysis [J].
Hegazy, HM ;
Carrau, RL ;
Snyderman, CH ;
Kassam, A ;
Zweig, J .
LARYNGOSCOPE, 2000, 110 (07) :1166-1172