Intrathecal Fluorescein in Endoscopic Skull Base Surgery for Identification and Repair of Cerebrospinal Fluid Leaks (Preview)

 Vladimir Neknendzy, M.D.

We are very pleased to offer for your attention a carefully compiled guide for a safe use of intraoperative intrathecal fluorescein to assist the endoscopic repairs of the cerebrospinal fluid (CSF) leaks.

What remarkable about this guide is that it was spearheaded by the SHANA forum discussion. Dr. Callum Gilchrist from the Royal North Shore Hospital in Sydney, Australia initiated the discussion and subsequently took on a self-imposed task to perform a thorough literature review, write up the guide, and share it with the SHANA community. The SHANA Education Board is very pleased that the professional collegiality and informative discussions have proved useful at the point of clinical care.

Congratulations to Dr. Callum Gilchrist on the job well done!

Intrathecal Fluorescein in Endoscopic Skull Base Surgery for Identification and Repair of Cerebrospinal Fluid Leaks.

 Presented by Dr. Callum Gilchrist, Royal North Shore Hospital, Sydney, Australia.

The endoscopic repair of cerebrospinal fluid (CSF) leaks is currently considered the standard of surgical care. Although preoperative high-resolution imaging studies are routinely performed for these cases, the intraoperative intrathecal (IT) fluorescein dye injection pinpoints the localization of the actual defect, facilitating surgical repair. The patient’s safety will be greatly enhanced by the use of a low-dose fluorescein (e.g. 0.1% - 10 ml) and other perioperative precautions, outlined below...
 

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