Back to Search
Start Over
The efficacy and safety of intrathecal fluorescein in endoscopic cerebrospinal fluid leak repair -a systematic review.
- Source :
-
Auris Nasus Larynx . Dec2022, Vol. 49 Issue 6, p912-920. 9p. - Publication Year :
- 2022
-
Abstract
- <bold>Background: </bold>Effective management of cerebrospinal fluid (CSF) leaks can reduce significant associated morbidity. Intrathecal fluorescein (IF) may be a valuable intra-operative adjunct to localise leak sites. Recent reports have demonstrated low doses of IF to be safe, however, no internationally accepted dose of IF has been agreed.<bold>Objective: </bold>To assess the efficacy and safety of IF used in the endoscopic management of anterior skull base CSF fistulae.<bold>Methods: </bold>A systematic review and descriptive analysis were performed of all published data in accordance to PRISMA guidelines.<bold>Results: </bold>There were 18 included articles giving a total of 335 procedures where IF was used. Doses of IF ranged from 10mg - 150mg. IF positively identified the site of CSF fistula in 88.7% of cases (n = 297). There was a total of 25 reported peri-operative complications in all included studies (7.5%) with 5.1% (n = 17) potentially related to IF use. Of these, the complication rate was 3.9% at low IF doses (<50mg) and 80.0% at higher doses (≥50mg).<bold>Conclusion: </bold>Our review demonstrates that IF is effective at localising CSF fistulae with most significant complications being related to doses ≥50mg. We therefore propose that there is a potential for the licensing of IF in this field. Doses <50mg have consistently been shown to be safe while still maintaining effective localisation rates. Based on the most common doses used in this group, we recommend utilisation of a dosing below 50mg, with the most frequent range being between 10-30mg. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 03858146
- Volume :
- 49
- Issue :
- 6
- Database :
- Academic Search Index
- Journal :
- Auris Nasus Larynx
- Publication Type :
- Academic Journal
- Accession number :
- 157799751
- Full Text :
- https://doi.org/10.1016/j.anl.2022.03.014