Three months ago, I was in a car accident. After two months of my nose bothering me, I mentioned to my neurologist about my nose. She referred me to an ENT who confirmed my nose was broken. The doctor performed a procedure to open up the nasal passage and gave me Nasonex for two weeks. Do you think I need plastic surgery? I am still having continued pain and tenderness on my nose and facial area and my nose is constantly dripping, now even more after my doctor performed procedure. What do you suggest I do?
Plastic Surgery for Broken, Painful, and Dripping Nose?
Doctor Answers 5
Without having specific details regarding your accident and your recent surgery I can only postulate some of the concerns. WIth persistent nasal dripping, I would first want to determine if you have a cerebrospinal fluid leak from a skull fracture. This can happen with trauma to the nose and face. This can be evaluated by a simple test of checking the fluis, but also with a CT scan.
As the other doctors have mentioned, you should be re-evaluated by your ENT. The dripping, especially of clear colored fluid is a bit trouble some and you should mention this to your doctor as soon as possible.
Plastic surgery for broken, painful, and dripping nose?
I completely agree with Drs. Francis and Placik.
The fact you are seeing a neurologist suggests to me that a CT scan MAY have been done. I would have it read again looking specifically to see if the nasal fracture involved the junction between the nose and base of the brain.
Having a fracture there (sometimes called LeFort III fracture) literally forms a communication with the fluid on which the brain floats. The nasal fluid MUST be checked to make sure it is NOT cerebrospinal fluid. This WILL require a neurosurgical procedure to stop the leak and block the communication to prevent an infection involving that space.
Ask your ENT surgeon IF he considered such a fracture. You may consider consulting independently with a neurosurgeon.
I hope this was helpful.
Peter A Aldea, MD
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Dear Ms./Mr. Jung,
I would recommend close follow up with your surgeon, whether that be an ENT or a plastic surgeon. Dripping from the nose after head and nasal trauma may be cerebrospinal fluid from the brain and could cause significant risk to you. The management of this kind of problem may involve a neurosurgeon as well. Good luck!
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