2026 Poster Presentations
P259: DEVELOPMENT OF A RAPID POINT-OF-CARE DIAGNOSTIC KIT FOR DIFFERENTIATING CEREBROSPINAL FLUID (CSF) RHINORRHEA FROM BENIGN NASAL DISCHARGE: AN EARLY MULTIDISCIPLINARY APPROACH IN THE CONTEXT OF SKULL BASE RECONSTRUCTION
Young Il Kim, PhD1; Yeon Hee Im, PhD2; Kyuha Chong, PhD3; Rowoon Park, PhD4; Ho Sang Jung, PhD4; Seung Ho Yang, PhD1; 1Department of Neurosurgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Koarea; 2Department of Otorhinolaryngology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Koarea; 3Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine; 4School of Biomedical Engineering, College of Health Science, Korea University
Accurate differentiation between cerebrospinal fluid (CSF) and nasal discharge is a critical yet unresolved clinical challenge following endoscopic skull base surgery and traumatic basal skull fractures. Currently available diagnostic methods, including β2-transferrin assays and glucose concentration analysis, are widely used in clinical practice. However, these methods are limited by high costs, delayed turnaround times, and inconsistent diagnostic accuracy across different clinical scenarios. Consequently, there is still no rapid and reliable point-of-care diagnostic tool that enables timely decision-making in operative and acute care settings.
To address this unmet need, we have initiated a project to develop a rapid, field-deployable diagnostic kit capable of differentiating CSF from nasal discharge in real-world environments such as the operating room, emergency department, and outpatient clinic. From the outset, this project has emphasized interdisciplinary collaboration, particularly between neurosurgeons, otolaryngologists, and materials scientists. The involvement of otolaryngology is essential, as both the clinical characteristics and anatomical origins of nasal secretions must be considered to achieve accurate differentiation.
In the current exploratory phase, we are focusing on candidate biomarkers that may provide both specificity and practicality for rapid detection. Beyond β2-transferrin, which has established clinical utility, we are investigating proteins including S100β, prostaglandin D synthase (hematopoietic isoform), Tau protein, and SPP1. While clinical sample collection has not yet commenced, preliminary validation is being conducted using simulated fluid testing and biosensor platform evaluation. These preclinical studies aim to confirm feasibility and optimize assay conditions before transitioning to patient-derived samples. Subsequent validation with clinical specimens will be carried out in collaboration with the otolaryngology department to ensure translational accuracy and applicability.
Although still in its early stage, this project directly addresses a recognized diagnostic gap in skull base surgery and traumatic CSF leak management. By integrating clinical expertise and biosensor technology, we aim to develop a rapid and practical diagnostic tool that enhances intraoperative and perioperative safety and improves outcomes in patients with suspected CSF leakage.