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Development of a shortwave infrared sinuscope for the detection of cerebrospinal fluid leaks.
J. Biomed. Opt. 28:094803 (2023)
Verlagsversion
DOI
PMC
SIGNIFICANCE: Cerebrospinal fluid (CSF) rhinorrhea (leakage of brain fluid from the nose) can be difficult to identify and currently requires invasive procedures, such as intrathecal fluorescein, which requires a lumbar drain placement. Fluorescein is also known to have rare but significant side effects including seizures and death. As the number of endonasal skull base cases increases, the number of CSF leaks has also increased for which an alternative diagnostic method would be highly advantageous to patients. AIM: We aim to develop an instrument to identify CSF leaks based on water absorption in the shortwave infrared (SWIR) without the need of intrathecal contrast agents. This device needed to be adapted to the anatomy of the human nasal cavity while maintaining low weight and ergonomic characteristics of current surgical instruments. APPROACH: Absorption spectra of CSF and artificial CSF were obtained to characterize the absorption peaks that could be targeted with SWIR light. Different illumination systems were tested and refined prior to adapting them into a portable endoscope for testing in 3D-printed models and cadavers for feasibility. RESULTS: We identified CSF to have an identical absorption profile as water. In our testing, a narrowband laser source at 1480 nm proved superior to using a broad 1450 nm LED. Using a SWIR enabling endoscope set up, we tested the ability to detect artificial CSF in a cadaver model. CONCLUSIONS: An endoscopic system based on SWIR narrowband imaging can provide an alternative in the future to invasive methods of CSF leak detection.
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Publikationstyp
Artikel: Journalartikel
Dokumenttyp
Wissenschaftlicher Artikel
Schlagwörter
Nir-ii ; Cerebrospinal Fluid Leak ; Endoscopy ; Shortwave Infrared ; Sinuscopy ; Skull Base Surgery; Intrathecal Fluorescein
ISSN (print) / ISBN
1083-3668
e-ISSN
1560-2281
Zeitschrift
Journal of Biomedical Optics
Quellenangaben
Band: 28,
Heft: 9,
Artikelnummer: 094803
Verlag
SPIE
Verlagsort
1000 20th St, Po Box 10, Bellingham, Wa 98225 Usa
Nichtpatentliteratur
Publikationen
Begutachtungsstatus
Peer reviewed
Institut(e)
Helmholtz Pioneer Campus (HPC)
Förderungen
Helmholtz Zentrum Munchen
National Center for Tumor Diseases Dresden
Helmholtz Imaging Platform
DFG-Emmy Noether Program
CZI Deep Tissue Imaging
National Center for Tumor Diseases Dresden
Helmholtz Imaging Platform
DFG-Emmy Noether Program
CZI Deep Tissue Imaging