Any suggestions for clear leakage after Rhinoplasty?

Question

I had rhinoplasty a year and half ago and a fix six months ago. I have constantly a runny nose on one side. I don't know what it is and my surgeon I refuse to see. I have had a ct scan and mri since. Could this be CSF or would the neurologist have caught this from my brain scans? I don't really get head aches. Just dizziness and leaking of my nose at times. I am so scared I have CSF now. Help please!

Umang Mehta, MD · Answer

CSF leak is a very rare complication after rhinoplasty. I'd recommend you make an appointment with an ENT or rhinologist (sinus surgeon) in your area. They can collect the fluid and send it for a test to see if it is actually CSF. The MRI or CT may not have seen the leak site if it is very small. There may be ways to patch up the leak through minimally invasive endoscopic surgery. A sinus specialist would be best able to advise you. Best regards,Dr. Mehta

Sirius K. Yoo, MD · Answer

Thank you for your question.  CSF leak would be a very rare, but possible complication of rhinoplasty.  This is more likely to be thin, clear mucous than CSF.  Sometimes when people have allergies, after rhinoplasty, they actually breath better, but that means the allergens are able to get up into the nose more readily and exacerbate symptoms.  I'm not saying that is what is going on, just that it is a possibility.  CSF leak is associated with intermittent gushes of fluid when you bend over or turn over.  It usually has a salty taste.  Those characteristics are not diagnostic by any means.  The CT scan might indicate an area where there is interruption in the bone that separates the top of the nose from the brain, but it often does not, especially when the CT was not done with very fine cuts through the anterior skull base.  The bone of the skull base is paper thin in areas and finding a small break is difficult. MRI is generally not a good test for looking at this.  The best way to diagnose this is to look for a protein (beta-2-transferrin) uniquely found in CSF.  This usually involves collecting the clear drainage in a little cup and taking it to the lab for testing.  If positive, it means you have a CSF leak.  CSF leak is important because if fluid can get out, bacteria can get in.  So, a feared complication of CSF leak is meningitis.  I recommend you see an otolaryngologist who can evaluate you thoroughly and make sure you just have a runny nose and not a CSF leak.  All the best!

Vincent N. Zubowicz, MD · Answer

Leaking of cerebrospinal fluid after rhinoplasty would be a very very rare complication. Still, it's possible. This is potentially dangerous and should be worked up. I'm not sure why you don't want to see your surgeon.Perhaps you should consult with a neurosurgeon.

Andrew Pichler, MD · Answer

Don't procrastinate ! The answers given so far basically covers everything well. You need to have this worked up quick. Good luck.

Fred Suess, MD (retired) · Answer

Clear leakage after rhinoplasty could be a "runny nose", are something more serious such as a cerebrospinal fluid leakage. Have this tested by a ear, nose and throat doctor, otolarayngologist or neurosurgeon.

Any suggestions for clear leakage after Rhinoplasty?

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Any suggestions for clear leakage after Rhinoplasty?

Answers (5)

Answer: Clear runny nose after rhinoplasty

Answer: Clear runny nose after rhinoplasty

Answer: Clear leakage after rhinoplasty

Answer: Clear leakage after rhinoplasty

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Everything you need to know about Rhinoplasty

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