Is there a potential for CSF leakage after sinus surgery?

Patient's Query

Hello doctor,

I had sinus surgery about four months ago, to correct a severely deviated septum and to reduce the turbinates on both sides. I also had surgery previously on my face to reconstruct an impacted orbital bone and maxillary sinus on the left side of my face. Following the surgery, on my sinuses and septum, I had a clear thin liquid that would drip from only my right nostril when I would bend down or bend over to get something. It was a very thin liquid and I assumed it was just fluid draining from the surgery and that it was normal. Since then the draining has continued to happen when I bend over. I was never told by my ENT that a CSF leak was a potential complication that could occur with this surgery but after researching this symptom I have found out otherwise. I have a follow up scheduled with my ENT doctor but that is not for another month and a half. Is there a potential that it could be a CSF leak? Could it be still recovering from the surgery? Should I look to see if I can see someone sooner than a month and a half?

Answer

Dr. Shyam Kalyan N

Allergy Specialist Otolaryngology (E.N.T)

Hello,

Welcome to icliniq.com.

With a septal correction and turbinate reduction surgery the chances of causing a CSF (cerebrospinal fluid) leak as complications are remote because CSF leak occurs when you disrupt the skull base and in the surgeries you mentioned we do not touch the skull base. However, you have mentioned in one place that it is sinus surgery. Sinus surgery does have CSF leak as one of the dreaded complications. Could you pull out the exact details of your surgery and let us know? If possible can you upload the preoperative sinus CT scan films and report for us to check.

Before we panic, get the fluid collected in a clean sterile container and check for sugar and beta transferrin. These two tests will help us know whether the fluid is nasal discharge or CSF. If it is CSF indeed then you need to immediately get it corrected. CSF leak denotes there are potential leak and opening in the base of the skull and that any infection or bacteria can easily pass on the nose to the brain.

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