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Taking Steroid, Nasal Spray And Afrin. What Is Causing Water Dripping From Nose While Bending?
Question: Hi I'm a 39 year old female with water dripping out of my nose when I bend over. It's not every time, maybe just once or twice a day. I take a steroid nasal spray and Afrin. I'm a little frightened because this I a newer symptom. No head trauma or anything. Healthy person.
Just checked my tissue and its relatively stiff. I think that's a good sign?
Thanks
Just checked my tissue and its relatively stiff. I think that's a good sign?
Thanks
Hi,
Thank you for your query.
1. You should get the fluid collected in a sterile container and get it tested to rule out a CSF (Cerebro Spinal Fluid) leak. Get a Beta-2 Transferrin test on the fluid, if available. A CSF on bending forwards is known as the 'Teapot Sign' or the 'Reservoir Sign'. The total quantity of CSf is about 150 ml and it is replenished about five times a day. That is why CSF leaks, especially low pressure ones, are not continuous.
2. A simple test is the 'Handerchief Test': Normal nasal secretions contain mucus which will stain and stiffen a soft handkerchief on drying, but CSF will not. Hence a stiff tissue is a good sign.
3. Get a CT PNS (Para Nasal Sinuses) done. If a CSF leak is suspected, a CT cisternography and MRI with contrast should be done. Spontaneous leaks may be multiple.
4. If you confirm that the fluid is not CSF then another possibility is a drug induced reaction with prolonged use of Afrin (oxymetazoline) which causes Rhinitis Medicamentosa (rebound congestion).
5. You should review your medication as an anti-allergic and an anti-leukotriene may help. Sometimes the nasal effects are due to the alteration of the Autonomous Nervous System by your current medications.
6. You may follow up with the answers to the above questions, results of the above investigations and treatment for further recommendations.
I hope that I have answered your queries. If you have any further questions, I will be available to answer them.
Regards.
Thank you for your query.
1. You should get the fluid collected in a sterile container and get it tested to rule out a CSF (Cerebro Spinal Fluid) leak. Get a Beta-2 Transferrin test on the fluid, if available. A CSF on bending forwards is known as the 'Teapot Sign' or the 'Reservoir Sign'. The total quantity of CSf is about 150 ml and it is replenished about five times a day. That is why CSF leaks, especially low pressure ones, are not continuous.
2. A simple test is the 'Handerchief Test': Normal nasal secretions contain mucus which will stain and stiffen a soft handkerchief on drying, but CSF will not. Hence a stiff tissue is a good sign.
3. Get a CT PNS (Para Nasal Sinuses) done. If a CSF leak is suspected, a CT cisternography and MRI with contrast should be done. Spontaneous leaks may be multiple.
4. If you confirm that the fluid is not CSF then another possibility is a drug induced reaction with prolonged use of Afrin (oxymetazoline) which causes Rhinitis Medicamentosa (rebound congestion).
5. You should review your medication as an anti-allergic and an anti-leukotriene may help. Sometimes the nasal effects are due to the alteration of the Autonomous Nervous System by your current medications.
6. You may follow up with the answers to the above questions, results of the above investigations and treatment for further recommendations.
I hope that I have answered your queries. If you have any further questions, I will be available to answer them.
Regards.
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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