Clear nasal dripping over a year post-op, help please?

Question

Hi! I had a primary rhinoplasty almost exactly a year ago. From the moment I had the surgery, I noticed that my nose would "drip" whenever I looked down, or did any sort of walking/exercise in cold weather. 6 months later, I went back to get a tweak with my original surgeon, and when I showed him the dripping, he scheduled a CT scan. The results came back and it’s not CSF. I have seen an ENT in Boston who confirmed the same. Have to carry tissues everywhere. I hate this. Help please.

Eric M. Joseph, MD · Answer

For reasons that are not completely clear, many people develop a runny nose after rhinoplasty surgery. The best advice for Many is to utilize a topical nasal antihistamine spray, like Astepro, along with a topical nasal steroid. Sometimes Atrovent nasal spray is helpful for drying up the nose. The other consideration might be a nonsedating antihistamine. I'm glad you do not have a CSF leak! Sincerely, Dr. Joseph

Ronald J. Edelson, MD · Answer

There is a prescription nasal spray that works perfectly for your situation.  It’s called atrovent. You should ask your ENT if you are a good candidate for it. I’m surprised this hadn’t been recommended already

Thomas Spalla, MD · Answer

I'm very relieved to hear that this is not CSF based on what you've said. A CT scan is definitely useful, but if you can collect about a teaspoon of the drippings, it should be checked for beta-2 transferrin, a highly specific marker for CSF. If this has been done, and is negative, of course, then you likely have vasomotor rhinitis, based on your description with it worsening during walking/exercise/cold.

Anticholinergic nasal sprays are often beneficial (e.g., Atrovent 0.03 or 0.06%). Some patients benefit from nasal corticosteroid sprays (e.g., Flonase, Rhinocort, etc), and some benefit from both.

If these fail, some ENT providers offer neural ablation to alleviate this issue.

Consult with an ENT or, more specifically, a rhinologist.

Clear nasal dripping over a year post-op, help please?

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Clear nasal dripping over a year post-op, help please?

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