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Anales de Otorrinolaringología Mexicana

2016, Number 2

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Otorrinolaringología 2016; 61 (2)

Diagnostic accuracy of glucose multirreactive strips and nephelometry for beta-2 transferrin measurement to confirm CSF rhinorrhea

García-Callejo FJ, Talamantes-Escribá F, Redondo-Martínez J, Quilis V, Pérez-Carbonell T, Goloney V

Language: Spanish
References: 28
Page: 100-109
PDF size: 478.78 Kb.


ABSTRACT

Objective: To evaluate the diagnostic effectivenes of two methods for detection of CSF in nasal exudates.
Material and Method: A longitudinal, prospective and descriptive study was developed to identify two molecules containing in CSF –glucose and beta-2 transferrin (BT)– which positivity in rhinorrheas makes to suspect a CSF leakage. We correlated glucose and BT detection considering the last one as the reference proof. Moreover, glucose and BT measurements were compared to image findings (CT and MR) and intrathecal markers injection, quantifying positive and negative falses.
Results: 52 individuals were diagnosed of CSF leakage from 157 with clinical suspect. A positive identifying of glucose was observed in 42 cases with fistula and 32 without it, taking as conditioning factors nasal sprays employment and diabetes. BT was detected on nasal exudade from 45 patients with fistula and 3 without it. Glucose test positive in front of image findings or intrathecal injection showed sensitivity of 57%, specificity of 88%, NPV of 69.5% and accuracy of 73%. These values for BT were 94%, 93.5%, 97% and 94%, respectively.
Conclusions: The ability to discard fistulae among subjects with rhinorrhea results similar in both laboratory techniques. Sensitivity and NPV increase substantially the diagnostic accuracy for BT. Glucose detection by mean of reactive strips is a valid screening tool of the picture because of its rapidity, accesibility and cost, but it is not possible to assume a warrant diagnosis of rhinoliquorrhea, keeping its employment for low-resource settings.


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