{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T18:51:56Z","timestamp":1784573516121,"version":"3.55.0"},"reference-count":17,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2010,11,1]],"date-time":"2010-11-01T00:00:00Z","timestamp":1288569600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2010,11]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>To evaluate the utility of intrathecal fluorescein (IF) for intraoperative localization and successful repair of cerebrospinal fluid (CSF) leaks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>STUDY DESIGN<\/jats:title>\n                    <jats:p>Case series with chart review.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>SETTING<\/jats:title>\n                    <jats:p>Tertiary\u2010care medical center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>SUBJECTS AND METHODS<\/jats:title>\n                    <jats:p>Subjects included those undergoing endoscopic CSF leak repair with or without the use of IF. Informed consent was obtained from all patients undergoing the administration of IF (total dose 10\u00a0mg).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      A total of 103 patients underwent CSF leak repair, and in 47 cases (45.6%), IF was used. Patients who were administered IF were more likely to have spontaneous CSF leak etiology (61.7% vs 16.1%;\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001). Of the 47 cases with IF use, fluorescein was visualized at the skull base in 31 cases (66.0%), 11 (23.4%) had visible CSF leak without fluorescein coloration, and five (10.6%) had neither clear nor fluorescein\u2010colored CSF visualized. Sensitivity and specificity for fluorescein detection was 73.8 percent (95% confidence interval [CI] 57.7%\u201085.6%) and 100 percent (95% CI 46.3%\u2010100%), respectively. The false\u2010negative rate was 26.2 percent (95% CI 15.8%\u201043.5%). Localization of the leak site was greater when fluorescein\u2010colored CSF was visualized (100% vs 81.3%;\n                      <jats:italic>P<\/jats:italic>\n                      = 0.035). When fluorescein\u2010colored CSF was not visualized intraoperatively, recurrence rates were 31.3 percent versus 9.7 percent when fluorescein coloration was seen, although this finding was not statistically significant (\n                      <jats:italic>P<\/jats:italic>\n                      = 0.10).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>The use of IF facilitates the accurate localization of CSF leaks and may assist the surgeon in confirming a watertight closure. The lack of intraoperative fluorescein visualization should not rule out the presence of CSF leak, as evidenced by a false\u2010negative rate of 26.2 percent.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.otohns.2010.07.011","type":"journal-article","created":{"date-parts":[[2010,11,4]],"date-time":"2010-11-04T04:18:00Z","timestamp":1288844280000},"page":"626-632","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":84,"title":["The utility of intrathecal fluorescein in cerebrospinal fluid leak repair"],"prefix":"10.1002","volume":"143","author":[{"given":"Rahul","family":"Seth","sequence":"first","affiliation":[{"name":"Head and Neck Institute Cleveland Clinic Cleveland OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karthik","family":"Rajasekaran","sequence":"additional","affiliation":[{"name":"Chicago Medical School at Rosalind Franklin University of Medicine and Science North Chicago 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