Use of an electronic nose to distinguish cerebrospinal fluid from serum

BACKGROUND: Efforts to mimic the biologic olfactory system have resulted in the development of an electronic nose, whereby volatile gases may be identified by means of organic semiconductors. Such devices have been used in the food and beverage industry for quality-control purposes, but to date have not been used in the field of medicine. OBJECTIVE: To present the application of an electronic nose for clinical decision making by assessing the ability of an electronic nose to distinguish cerebrospinal fluid (CSF) from serum. DESIGN: Randomized, prospective, masked study. SUBJECTS: Nineteen matched sets of CSF and serum from inpatients at a university hospital. RESULTS: The electronic nose was able to distinguish CSF from serum in 18 of 19 patients. The data points for 18 of 19 CSF and 18 of 19 serum samples were within statistically distinct cluster groups, suggesting that the device is able to identify an unknown sample as CSF or serum. CONCLUSIONS: This new technology is able to distinguish CSF from serum with a high degree of accuracy and speed, and with small sample quantity, potentially allowing the physician to identify reliably CSF otorrhea or rhinorrhea. This revolutionary diagnostic approach may have further, widespread application in the field of otorhinolaryngology and in medicine as a whole.