Cerebrospinal Fluid Leak
Conditions
Brief summary
The purpose of this research is to test the use of Acetazolamide in preventing post-operative cerebrospinal fluid leak in patients having endoscopic skull base surgery (it is a surgery performed through the nose and sinus).
Interventions
DRUGAcetazolamide
Acetazolamide 500 mg by mouth twice per day for 5 days
Sponsors
University of Miami
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Elective transsphenoidal resection of a tumor expected to result in an intraoperative high flow CSF leak; such tumors include craniopharyngioma, meningioma, and Rathke cleft cyst. * Elective transsphenoidal resection of a pituitary adenoma, with BMI \>25, or with observed low or high flow CSF leak during surgery, conferring an elevated risk of postoperative CSF leak. * Patients who voluntarily sign Informed Consent * Male subjects and female subjects of childbearing potential and at risk for pregnancy must agree to use a highly effective method of contraception during study treatment and for at least 1 month after stopping study treatment. Male subjects should refrain from donating semen during treatment and 1 month after stopping treatment.
Exclusion criteria
* Adults unable to consent * Individuals who are not yet adults (infants, children, teenagers) * Pregnant women * Prisoners * Patients with prior adverse reactions to acetazolamide or who are taking aspirin concomitantly (which may increase the risk of adverse reactions to acetazolamide) * Patients with moderate to severe chronic obstructive pulmonary disease (which may increase the risk of adverse effects of acetazolamide) * Acetazolamide therapy is contraindicated in situations in which sodium and/or potassium blood serum levels are depressed, in cases of marked kidney and liver disease or dysfunction, in suprarenal gland failure, and in hyperchloremic acidosis. * It is contraindicated in patients with cirrhosis because of the risk of development of hepatic encephalopathy * Sulfonamide allergy * Pregnant females, breastfeeding females, and males and females of childbearing potential who are unwilling or unable to use a highly effective method of contraception
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of CSF Leakage | 30 days | Occurrence of postoperative CSF leak within 30 days of surgery confirmed on clinical exam as well as on CT scan, endoscopic visualization, or confirmation via beta transferrin testing. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of suspected drug adverse events | 14 days | Treatment emergent adverse events as assessed by treating physician discretion. |
Outcome results
None listed