García-Callejo FJ, Martínez-Expósito F, Balaguer-García R, García-Aguayo JM, Alba-García JR, Juantegui-Azpilicueta M

Language: Spanish
References: 0
Page: 71-79
PDF size: 171.96 Kb.

ABSTRACT

Objective: To assess and validate the reliability offered by the double quantitative determination of glucose and total proteins in nasal secretions for the identification of cerebrospinal fluid (CSF); leaks against tests of greater sensitivity and cost.
Patients and Method: A prospective, longitudinal, observational, comparative study was done from March 2017 to August 2019 measuring glucose and total protein levels in CSF and nasal exudate samples. With these data, a calculation tool was carried out with both parameters on 84 suspected cases of fistula, comparing its diagnostic accuracy with that of β2-transferrin as well.
Results: There were included 84 suspicious cases; there were statistically significant differences in mean glucose and total protein concentrations in CSF and nasal mucus samples. CSF leakage was confirmed in 24 of 84 cases with fistula suspicion. Nasal samples with glucose › 40 mg/dL and total proteins ‹ 100 mg/dL had sensitivity of 88%, specificity of 89.8%, positive predictive value of 78.5%, negative of 94.6% and accuracy of 89.2%.
Conclusions: The quantitative determination of glucose and total protein improves the sensitivity of glucose alone in the diagnosis of CSF leaks and offers accuracy indicators slightly lower than those of β2-transferrin, so they could be used as a valid diagnostic tool for its cost, availability and quickness in obtaining the result.