{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T04:19:12Z","timestamp":1791346752181,"version":"4.3.1"},"reference-count":10,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurol Surg B Skull Base"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Objective\u2003Diagnosis of cerebrospinal fluid (CSF) leaks is sometimes challenging in the postoperative period following pituitary and ventral skull base surgery. Intrathecal fluorescein (ITF) may be useful in this setting.<\/jats:p><jats:p>\n          Design\u2003Retrospective chart review.<\/jats:p><jats:p>\n          Setting\u2003Tertiary care center.<\/jats:p><jats:p>\n          Methods and Participants\u2003All patients who underwent pituitary and ventral skull base surgery performed by a single rhinologist between January 2017 and March 2020 were included. There were 103 patients identified. Eighteen patients received 20 ITF injections due to clinical suspicion for CSF leak during the postoperative period without florid CSF rhinorrhea on clinical exam. Computed tomography scans with new or increasing intracranial air and intraoperative findings were used to confirm CSF leaks. Clinical courses were reviewed for at least 6 months after initial concern for leak as the final determinate of CSF leak.<\/jats:p><jats:p>\n          Main Outcome Measures\u2003Specificity and safety of ITF.<\/jats:p><jats:p>\n          Results\u2003Eleven (61%) ITF patients were female and 7 (39%) were male. Average patient age was 52.50\u2009\u00b1\u200911.89. There were six patients with confirmed postoperative CSF leaks, 3 of whom had evaluations with ITF. ITF use resulted in 2 true positives, 1 false negative, 17 true negatives, and 0 false positives. ITF sensitivity was 67%, specificity was 100%, and positive and negative predictive values were 100 and 94.4%, respectively. There were no adverse effects from ITF use.<\/jats:p><jats:p>\n          Conclusions\u2003Existing modalities for detecting postoperative CSF leaks suffer from suboptimal sensitivity and specificity, delayed result reporting, or limited availability. ITF represents a specific and safe test with potential utility in the postoperative setting.<\/jats:p>","DOI":"10.1055\/a-1722-4433","type":"journal-article","created":{"date-parts":[[2021,12,17]],"date-time":"2021-12-17T01:36:41Z","timestamp":1639705001000},"page":"017-023","source":"Crossref","is-referenced-by-count":2,"title":["Detection of Cerebrospinal Fluid Leaks Using the Endoscopic Fluorescein Test in the Postoperative Period following Pituitary and Ventral Skull Base Surgery"],"prefix":"10.1055","volume":"84","author":[{"given":"Peter A.","family":"Benedict","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, NYU Langone Health, New York, New York, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7079-3304","authenticated-orcid":false,"given":"Joseph R.","family":"Connors","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, NYU Langone Health, New York, New York, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Micah R.","family":"Timen","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, NYU Langone Health, New York, New York, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nupur","family":"Bhatt","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, NYU Langone Health, New York, New York, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard A.","family":"Lebowitz","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, NYU Langone Health, New York, New York, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donato R.","family":"Pacione","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, NYU Langone Health, New York, New York, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seth M.","family":"Lieberman","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, NYU Langone Health, New York, New York, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2022,1,18]]},"reference":[{"issue":"03","key":"ref1","doi-asserted-by":"crossref","first-page":"621","DOI":"10.3171\/2014.12.JNS14995","article-title":"Sensitivity and specificity of intrathecal fluorescein and white light excitation for detecting intraoperative cerebrospinal fluid leak in endoscopic skull base surgery: a prospective study","volume":"124","author":"S M Raza","year":"2016","journal-title":"J Neurosurg"},{"issue":"05","key":"ref2","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1016\/j.otohns.2010.07.011","article-title":"The utility of intrathecal 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evidence-based review with recommendations","volume":"6","author":"G M Oakley","year":"2016","journal-title":"Int Forum Allergy Rhinol"},{"issue":"04","key":"ref10","doi-asserted-by":"crossref","first-page":"961","DOI":"10.3171\/2014.5.JNS132028","article-title":"Pneumocephalus patterns following endonasal endoscopic skull base surgery as predictors of postoperative CSF leaks","volume":"121","author":"M A Banu","year":"2014","journal-title":"J Neurosurg"},{"issue":"10","key":"ref11","doi-asserted-by":"crossref","first-page":"901","DOI":"10.2165\/11208340-000000000-00000","article-title":"Spotlight on levetiracetam in epilepsy","volume":"25","author":"K A Lyseng-Williamson","year":"2011","journal-title":"CNS Drugs"}],"container-title":["Journal of Neurological Surgery Part B: Skull 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