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Ear, Nose, and Throat Disorders

Spinal fluid leak

10/11/2007

Question:

My e.n.t. doctor said I might have a spinal fluid leak. Fluid drains from my nose just one nostril is affected. I have had two sinius surgies and two mastoidectomies and last I have had two surgies on my cervical disc at the four five level. This scares me and my doctor did not explain it very well. If you could give me some info. I would appreciate it.

Answer:

Both the mastoid cavity and the sinuses border on what is referred to as the skull base.  This is bone that separates these structures from the brain.  This bone can sometimes be very thin, particularly if you've had chronic infections.

The brain is surrounded by a protective layer of fluid, spinal fluid.  If there is a perforation of the bone that makes up the roof of the mastoid or the sinus cavity, it is possible that spinal fluid can leak into the mastoid or the sinuses.  From the mastoid it could drain down the eustachian tube to the nose, or certainly if it drained into the sinuses it could also leak out of the nose.  It would tend to present as clear fluid generally draining from one side of the nose.

Of course, mucus also drains from the nose, so there is no need to panic.  There are methods to test this drainage to determine if it is spinal fluid or mucus.  I would consult your ENT doctor to pursue this further.      

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Response by:

Allen M Seiden, MD Allen M Seiden, MD
Professor of Otolaryngology, Director of Division of Rhinology and Sinus Disorders, Director of University Taste and Smell Center, Director of University Sinus and Allergy
College of Medicine
University of Cincinnati