[Diagnostic value of radioisotope cisternography combined with intranasal pledgets in CSF rhinorrhea].
The experience with the radioisotope cisternography in 17 cases without CSF rhinorrhea for control study and one with CSF rhinorrhea at Tokyo Medical and Dental University Hospital is reported. In addition to the usual cisternography, we used intranasal pledgets for identification and localization of CSF rhinorrhea. The cotton pledgets are placed in the following regions; 1) sphenoethmoid recess, 2) middle meatus and 3) cribriform region. The radioisotope (111In-DTPA, 1mCi) is introduced by lumbar puncture. After scintiphoto is taken at 4 hours, the pledgets are removed and the radioactivity are counted by well-type scintillation counter. The radioactivity of 1 ml of blood is also counted. There is close correlation between the radioactivity of nasal pledget and blood. The ratio of radioactivity of a pledget to that of blood was less than 0.3. The ratio of radioactivity in patient with CSF rhinorrhea is much greater than 0.3. The usefulness of these combined method for identifying the fistulous tract so that surgeon can carry out a direct operation is emphasized.