metrizamide and Paranasal-Sinus-Diseases

Demonstration of the exact site of dural fistulas in cases of cerebrospinal fluid rhinorrhea is difficult. Previous reports have described the use of metrizamide cisternography combined with either hypocycloidal tomography or computerized tomography; however, direct, dynamic, real-time visualization of the fistula is difficult with instillation of a minimal dose of metrizamide using those methods. A digital video subtraction fluoroscopy system can visualize the actual site of the fistula directly and dynamically using only a small amount of metrizamide.

Topics: Adult; Cerebrospinal Fluid Rhinorrhea; Dura Mater; Fistula; Fluoroscopy; Humans; Male; Metrizamide; Middle Aged; Myelography; Paranasal Sinus Diseases; Radionuclide Imaging; Subtraction Technique; Tomography, X-Ray Computed

Metrizamide computerized tomographic cisternography (MCTC) has proved 100% successful in documenting the precise anatomic location of the dural osseous defect in three patients with sphenoethmoidal rhinorrhea. In each patient, direct surgical approach to the site indicated by MCTC terminated the leakage in a single procedure. Clinical evaluation has disclosed no renewed leakage during a follow-up period from 6 to 18 months.

Topics: Cerebrospinal Fluid Rhinorrhea; Ethmoid Sinus; Female; Follow-Up Studies; Humans; Male; Metrizamide; Middle Aged; Myelography; Paranasal Sinus Diseases; Sphenoid Sinus; Tomography, X-Ray Computed