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CSF Leak?

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gunns:
I'm seven months post-op (retrosig) (July 2017).  A couple weeks post-op I had fluid coming from my left nostril (AN side).  I reported this to my surgeon during my post-op follow up visit.  There wasn't much fluid and it was intermittent.  They weren't able to collect and fluid during the visit.  The surgeon decided to take a wait and see approach and advised me to take it easy for a while in hopes that if it was a CSF leak that it would heal on it's own.
 Eventually it stopped.  At that time I knew very little about CSF leaks and just wrote the whole thing off and forgot about it.  A couple months later I started getting a runny nose occasionally.  I wrote it off as a sinus issue.  It got progressively worse a little at a time.  Last Friday while working on our property had to wipe my left nostril every 10 seconds or so.  It was bad enough that I gave up on tissue and had to use paper towels.  The fluid comes out of my left (AN side) and occasionally, 5% of the time, the right side as well.  It never comes out of the right side only.

 I've read up a fair amount about CSF leaks lately.  The fluid is crystal clear and has the same viscosity as tap water.   I've not had the headaches which I was familiar with from back surgeries.  Me eye sight can get a little blurry at times and my depth perception is off.  I still get the wonky headedness and use a cane and my balance is poor at times.

Last Friday, because it was so bad, I called and made an appointment with the ENT that took part in the surgery last year.  I saw him this last Monday.  He doesn't think it's a CSF leak because of fluid in both nostrils (even though it's only that way 5% of the time) and he didn't observe any fluid behind my left eardrum (what?).  Not sure what the eardrum check is all about and forgot to ask.  As with my first check for a possible CSF leak several months ago I wasn't able to get any fluid for testing during the office visit.  It seems to be at it's worst when I'm stressed/working hard which I assume increases the pressure on the CSF.  He did order a CT scan so it's wait and see for now.

I've heard about using glucose urine test strips to check for CSF leaks.  Mucus discharge doesn't have glucose in it and CSF does.  I ordered some today off of Amazon ($17.00) and they should be here this Friday.  It'll be interesting to see how that test turns out while waiting for the CT.

As we all know here on this site this AN thingie is a real life changer and I'm having trouble adjusting to it.  Even at my age, 70 this year, I've been extremely busy.  My life was filled with long years in martial arts, motorcycles (dirt and street) surfing, SCUBA diving, backpacking, some rock climbing and building my own home.  Being idle drives me nuts!

Feel free to provide advice, ask questions or just jump in and poke fun at me.  LOL!!!  Wishing everyone going through this challenge "Fair Winds and a Following Sea!

tarheelEH:
You can collect the fluid in a sterile (clean) tube and ask doctor send out for testing of Beta-2-Transfferin, it is 100% accurate but takes a week to get the result. I too went to USC have my tumor removed by Dr. F and G last September 2017.  This January I have dripping from AN side's nostril, drop-wise intermittently then progressively to easily collect 4-6 ml a day. I don't have any headache nor other symptoms.  It happened mostly when I am standing; and not really drip down when I bend forward.  Dr. Friedman initially doesn't think it is CSF leak, but I went ahead to have local ENT checked and result came back positive.   Dr. Friedman quickly squeezed me into his OR slot and I flew to San Diego last week to have it repaired. Its an outpatient procedure and I am recuperated home now.  He found the fat grafted shift a little and that fascia/wax they used float in middle ear.   Experienced ENT doctor can easily check middle ear's tympanic membrane, if he sees pulse movements that means the CSF is leaked into behind the ear drum.   Best luck and Hope this help a little.

gunns:
Thanks for the input.  You mentioned shifting of the fat graft and wax floating in your inner ear.  Did you have an earlier CSF repair - the one last week being the second?

tarheelEH:
No, this is the first CSF surgery after translab 4-5 months ago. Sorry delay in reply to you, I wasn't on computer a few days.
Doctor really didn't give a reason why the fat shift a bit and many bone fascia float around.  May be everyone's bone structure inside the skull varies or may be the cavity is larger than they realized. They saw lots fluid retains in mastoid air cell.

gunns:
Not to worry tarheelEH. I don’t check every day either. I have CT scan scheduled in a week or so. So it’s sit tight for now. So they used belly fat and wax to plug the leak?  Is the plug inserted on the brain side of the sinus/bone structure?  Or is it placed on the sinus side?  The former makes more sense to me. Just curious. Thanks for your time guy!!!!

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