Background: Hypodense fluorescein solution can be used intrathecally to facilitate and accelerate the identification of the fistulous site.
Methods: Eighteen patients were submitted for nasal endoscopic correction of rhinogenic cerebrospinal fluid fistulas after their identification with a hypodense sodium fluorescein solution.
Results: Intrathecal injection of hypodense fluorescein permitted a rapid and safe identification of the leak and did not present significant side effects. The fistulous site was identified in all patients, and the time needed for staining was <30 minutes in all cases. Surgery was successful in 88% of the patients after only one intervention, with the rate reaching 100% after a secondary intervention in cases of recurrence.
Conclusion: Intrathecal injection of a hypodense sodium fluorescein solution permits a more precise, rapid, and safe endoscopic approach, with no need to place the patient in the Trendelenburg position or to wait for a long period of time before starting the surgical procedure.