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ENT Trauma of Nose and Face a30f10bf

Halo sign and handkerchief test are positive in-

A
CSF Rhinorrhoea
B
Deviated nasal septum
C
Nasal Myiasis
D
Choanal atresia
High-Yield Explanation
Ans. is 'a' i.e., CSF Rhinorrhoea Detection of CSF Leak in CSF Rhinorrhoea1) Biochemical testso Concentrations of Glucose are higher in CSF than in nasal discharge. Glucose value > 30-40 mg% protein value <100 mg % (max 200 mg %) support a diagnosis of CSF leako Presence of b2 transferrin is the most definitive test for detection of CSF and b2 transferrin assay is the test of choice when a confirmatory test is needed, because of high sensitivity as well as specificity.o b-trace protein (prostaglandin D synthase) is also used, however it is nonspecific as it is also present in human testes, heart and seroma.2) Basic clinical testso Tissue test (Handker chief test):- Unlike nasal mucous, CSF does not cause a tissue to stiffeno Filter paper test:- Sample of nasal discharge on a filter paper exhibits a light CSF border and a dark central area of blood, i.e., double ring sign or halo sign.o Queckensted test:- Compression of the jugular vein leas to increased CSF leak due to increase in ICPo Rhinoscopy:- Visualization of CSF leak from paranasal sinus.3) CSF tracerso Intrathecal fluorescein dye adminstration, radionuclide cisternography, CT cisternography.

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