A Makeshift Blue Light Filter for Endoscopic Identification of Traumatic Cerebrospinal Fluid Leak Using Fluorescein

Abstract

ABSTRACT Objective: To describe a makeshift blue light filter for endoscopic visualization of a traumatic cerebrospinal fluid leak repair using intrathecal fluorescein and its application in one patient. Methods: Study Design:Surgical Instrumentation Setting:Tertiary Government Training Hospital Patient:One Results: Intra-operative endoscopic identification of fistulae sites was achieved using intrathecal injection of fluorescein that fluoresced using our makeshift blue light filter in a 43-year-old man who presented with a 3-month history of rhinorrhea due to skull base fractures along with multiple facial and upper extremity fractures he sustained after a fall from a standing height of 6 feet. He underwent transnasal endoscopic repair of cerebrospinal fluid fistulae in the planum sphenoidale, clivus and sellar floor. Post-operatively, there was complete resolution of rhinorrhea with no complications noted. Conclusion: Our makeshift blue light filter made from readily available materials may be useful for endoscopic identification of CSF leaks using fluorescein in a low- to middle-income country setting like ours.

Keywords

• rhinorrhea
• CSF leak
• cerebrospinal fluid fistula
• basilar skull fracture
• posterior cranial fossa
• post-traumatic cerebrospinal fluid leakage