What could be the reason for nose drainage after FESS?

Question

Hello doctor,

I had a FESS done before five months. Shortly after I noticed clear drainage from my nose. I had a pledget study done that confirm a bilateral CSF leak. Five weeks ago, I had sx to repair it, however in sx under intrathecal fluorescein, and the surgeon could not locate the leak. Nose still leaking and Beta 2 transferrin test came back negative. On Atrovent, for two days nose still drips, especially when bending over. Do I get a second opinion or assume it is caused by chronic rhinitis and start on a nasal spray that combines a steroid or antihistamine in it as my surgeon suggests? I never had any problems with a runny or drippy nose like this until after I had my sinus surgery.

Answer 1

Hello,

Welcome to icliniq.com.

CSF rhinorrhea is a known complication of extensive FESS (functional endoscopic sinus surgery). If a pledget had shown confirmed CSK leak, it sure needs to be investigated. Small leaks heal and recover by themselves however, if the leak persists longer, then it needs to be sealed by endoscopic surgery. In your case, any watery discharge from the nose should not be ignored. Especially if the release is more during bending, coughing, straining lifting weight etc. You may need an MRI, but I suggest meet an ENT endoscopic surgeon for further treatment. Sometimes this can get serious, so it is essential to meet your doctor.