Endoscopic endonasal detection of cerebrospinal fluid leakage with topical fluorescein

We evaluated the effectiveness of intraoperative topical application of fluorescein to detect the leakage point of cerebrospinal fluid (CSF) rhinorrhea Three patients with CSF rhinorrhea were treated with an endoscopic endonasal technique Ten percent fluorescein was topically used for intraoperative localization of the leak site A change of the fluorescein color from brown to green due to dilation of CSF were recognized as evidence of CSF rhinorrhea We repeated the procedure to detect any small defects All CSF rhinorrheas were successfully repaired by this endoscopic endonasal approach Topical application of fluorescein is simple and sensitive for identifying intraoperative CSF rhinorrhea.