The Glucostix glucose test was nonspecific and insensitive compared with the beta-2 transferrin assay.
2015 Apr 28. Long follow-up is required before leveling successful repair as recurrences may occur very late. World Neurosurg. Glucose detection using Glucostix test strips is not recommended as a confirmatory test due to its lack of specificity and sensitivity (19). 322109-overview A nalysis of nasal secretions for glucose with glucose-oxidase test paper systems (Clinistix or Tes-Tape) is widely used clinically to confirm the presence of cerebrospinal fluid (CSF) rhinorrhea. | Click the image above to visit their site and download your copy!
Glucose estimation, although non-specific, is the most popular and readily available method of diagnosis. Neurosurgery. Minim Invasive Neurosurg. This method of detecting cerebrospinal fluid (CSF) rhinorrhea is not recommended as a screening or confirmatory laboratory test to detect the presence of CSF in the nasal cavity for the following reasons: Reducing substances present in the lacrimal-gland secretions and nasal mucus may cause false-positive results. CSF rhinorrhoea: the place of endoscopic sinus surgery. Adams AS, Russell PT, Duncavage JA, Chandra RK, Turner JH. Beta-2 transferrin test confirms the diagnosis.
[Management of cerebrospinal fluid fistulae: physiopathology, imaging and treatment].
Background: This report describes the sensitivity and specificity of glucose detection using Glucostix test strips and computed tomography (CT) of the skull base for confirming cerebrospinal fluid (CSF) fistulae in patients with persistent rhinorrhoea or otorrhoea, and comparing them with the beta-2 transferrin assay as the gold standard for CSF detection. [Medline]. Otolaryngol Head Neck Surg. [Medline]. Spontaneous cerebrospinal fluid leaks in the anterior skull base secondary to idiopathic intracranial hypertension. Lanny Garth Close, MD is a member of the following medical societies: Alpha Omega Alpha, American Head and Neck Society, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American College of Physicians, American Laryngological Association, New York Academy of MedicineDisclosure: Nothing to disclose. Pneumocephalus on a CT scan may indicate a dural tear. Neurol India.
Factors associated with increased recurrences are middle age, obese female, raised ICP, diabetes mellitus, lateral sphenoid leaks, superior and lateral extension in frontal sinus, multiple leaks, and extensive skull base defects.
However, minute amounts of fluorescein resulting from small bony defects may be difficulty to detect using a rigid endoscope. Endonasal endoscopicrepair of cerebrospinal fluid rhinorrhea. DeConde AS, Suh JD, Ramakrishnan VR. The potential leak sites include the cribriform plate, ethmoid, sphenoid, and frontal sinus.
Arlen D Meyers, MD, MBA Professor of Otolaryngology, Dentistry, and Engineering, University of Colorado School of Medicine Appropriate treatment for raised ICP, in addition to proper repair, should be done to prevent recurrence. It is altered by the presence of renal failure, multiple sclerosis, cerebral infarction, and certain CNS tumors. Cerebrospinal fluid rhinorrhoea: diagnosis and management. Radioactive isotopes can be introduced into the CSF by means of a lumbar or suboccipital puncture. Br J Neurosurg. 2004 Aug. 114(8):1475-81. Resident Beta-2 transferrin is a CSF-specific variant of transferrin and is used as an endogenous marker of CSF leakage. Physician Assistant
1989 Mar;27(3):169-72. Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug ReferenceDisclosure: Received salary from Medscape for employment.
2011;54:110–4. 1992 Nov. 77(5):737-9. Cerebrospinal fluid (CSF) rhinorrhea occurs due to communication between the intracranial subarachnoid space and the sinonasal mucosa.