Efficiency of Various Methods of Identifying Cerebrospinal Fluid in Oto- and Rhinorrhea

Abstract

This paper describes methods of cerebrospinal fluid (CSF) leakage diagnosis which have been used in the post-war period. We have listed advantages and disadvantages and given our opinion as to the value of each method. In the form of comparison we have provided a detailed breakdown of the exact procedure of β₂ -transferrin identification used for the immunological diagnosis of CSF leakage. This method, which was developed further by us, is discussed with regard to the results of all sample analysis which have been carried out so far. The result of the discussion is to emphasize the many advantages of this method. In addition, there is a direct comparison made between the fluorescein method and the use of β₂-transferrin.

Retrospective validation of a β-trace protein interpretation algorithm for the diagnosis of cerebrospinal fluid leakage

“…Currently, two CSF rhinorrhea biomarkers with outstanding diagnostic characteristics are available routinely in clinical laboratory [8]. β 2 -Transferrin, the desialated isoform of transferrin, was the first specific and sensitive biochemical test available to the clinic [9]. The most common technique used to detect this molecule is immunofixation electrophoresis, which tends to be timeconsuming, expensive, and not readily available to every clinical laboratory [10,11].…”

Application of the Mimic Valsalva Maneuver with the Help of a Saccule in Cerebrospinal Fluid Rhinorrhea Reconstruction Surgery

“…Cerebrospinal fluid rhinorrhea corresponds to the leakage of cerebrospinal fluid through the nasal cavities [1,2]. Traumatic cerebrospinal fluid rhinorrhea usually occurs in the skull base.…”

The Management of Cerebrospinal Fluid Leaks in Patients at Risk for High-Pressure Hydrocephalus

“…Beta‐2 transferrin is a protein found in CSF, aqueous humor, and perilymph but not in blood or nasal secretions. Detection of β‐2 transferrin, based on standard, reproducible principles of protein electrophoresis and immunofixation, is a noninvasive, reliable chemical marker of CSF leakage 24–28 …”

“…Fluorescein is neurotoxic, and a low concentration–low volume injection is critical to avoid the neurological complications associated with higher concentrations. After intrathecal injection of the fluorescein solution, the CSF leak may be visualized using the nasal endoscope 24–29 . Under the Wood lamp (i.e., black light), fluorescein appears as bright yellow‐green; nonetheless, the yellowish color of fluorescein may be identified without the need for special lighting.…”