{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T11:26:44Z","timestamp":1784028404485,"version":"3.55.0"},"reference-count":11,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,3,20]],"date-time":"2025-03-20T00:00:00Z","timestamp":1742428800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Intrathecal fluorescein (IF) is effective for localizing nasal cerebrospinal fluid (CSF) leaks along the skull base during endoscopic exploration, with largest studies reporting sensitivities ranging from 66%\u201393%. Due to reports of intraoperative and postoperative neurologic complications such as seizures and paralysis, surgeons often dilute the fluorescein and inject it intrathecally slowly over a variable amount of time. However, no study has assessed whether rapid IF administration causes the aforementioned risks or whether it affects its accuracy in identifying CSF leaks intraoperatively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A prospective study was conducted from 2015 to 2024, where all patients undergoing endoscopic exploration and\/or repair of CSF rhinorrhea had 0.1\u2009mL of 10% fluorescein (10\u2009mg) mixed with 3\u20135\u2009mL of patients' CSF injected rapidly via the lumbar drain over a few seconds.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 82 included patients, the mean age was 53.8\u2009\u00b1\u200915.2\u2009years, and 84% were female. Sixty\u2010nine patients underwent successful endoscopic CSF leak repairs, and 13 had negative endoscopic explorations. Rapid IF injection was 80% sensitive (20% false negative rate) and 100% specific for identifying CSF leaks, and it caused no seizures, paralysis, or other neurologic complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Compared to prior reports of slow low\u2010dose IF injection for CSF leak localization, rapid IF injection yielded similar efficacy (80% sensitivity) with no IF\u2010related complications. Rapid IF injection was safe and effective but should be corroborated by future studies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4.<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.32135","type":"journal-article","created":{"date-parts":[[2025,3,20]],"date-time":"2025-03-20T08:31:03Z","timestamp":1742459463000},"page":"2696-2701","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Rapid Intrathecal Fluorescein Injection During Cerebrospinal Fluid Leak Repair Is Safe and Effective"],"prefix":"10.1002","volume":"135","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-9727-9107","authenticated-orcid":false,"given":"Hussein","family":"Mackie","sequence":"first","affiliation":[{"name":"Michigan State University College of Human Medicine  East Lansing Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob G.","family":"Eide","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1367-2052","authenticated-orcid":false,"given":"Abdul","family":"Yassin\u2010Kassab","sequence":"additional","affiliation":[{"name":"Michigan State University College of Human Medicine  East Lansing Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carl","family":"Wilson","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences Henry Ford Health  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0627-0349","authenticated-orcid":false,"given":"Amrita","family":"Ray","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Henry Ford Health  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam M.","family":"Robin","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Henry Ford Health  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karam","family":"Asmaro","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Henry Ford Health  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack P.","family":"Rock","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Henry Ford Health  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7377-4782","authenticated-orcid":false,"given":"John R.","family":"Craig","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Henry Ford Health  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,3,20]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21637"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2010.07.011"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/1945892419896243"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/19458924211020564"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.22947"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.3171\/2014.12.JNS14995"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anl.2022.03.014"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200402000-00016"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200004000-00006"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.2500\/ajr.2007.21.2972"},{"issue":"3","key":"e_1_2_7_12_1","first-page":"191","article-title":"A New Technique for the Use of Intrathecal Fluorescein in the Repair of Cerebrospinal Fluid Rhinorrhea Using a Hypodense Diluent","volume":"122","author":"Guimar\u00e3es R.","year":"2001","journal-title":"Revue de Laryngologie Otologie Rhinologie"}],"container-title":["The 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