Development of a shortwave infrared sinuscope for the detection of cerebrospinal fluid leaks

Tjadina Wencke Klein; Stella Yang; Mahbuba A. Tusty; Jayakar V. Nayak; Michael T. Chang; Oliver T. Bruns; Thomas S. Bischof; Tulio A. Valdez

doi:10.1117/1.JBO.28.9.094803

12 May 2023 Development of a shortwave infrared sinuscope for the detection of cerebrospinal fluid leaks

Tjadina Wencke Klein, Stella Yang, Mahbuba A. Tusty, Jayakar V. Nayak, Michael T. Chang, Oliver T. Bruns, Thomas S. Bischof, Tulio A. Valdez

Author Affiliations +

Journal of Biomedical Optics, Vol. 28, Issue 9, 094803 (May 2023). https://doi.org/10.1117/1.JBO.28.9.094803

Abstract

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.

CC BY: © The Authors. Published by SPIE under a Creative Commons Attribution 4.0 International License. Distribution or reproduction of this work in whole or in part requires full attribution of the original publication, including its DOI.

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Tjadina Wencke Klein, Stella Yang, Mahbuba A. Tusty, Jayakar V. Nayak, Michael T. Chang, Oliver T. Bruns, Thomas S. Bischof, and Tulio A. Valdez "Development of a shortwave infrared sinuscope for the detection of cerebrospinal fluid leaks," Journal of Biomedical Optics 28(9), 094803 (12 May 2023). https://doi.org/10.1117/1.JBO.28.9.094803

Received: 16 November 2022; Accepted: 1 March 2023; Published: 12 May 2023

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KEYWORDS

Short wave infrared radiation

Endoscopes

Polarizers

Light sources and illumination

Tissues

Cameras

Water

Significance

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