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Watery fluid from nostrils on laying, eye sockets pain.

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Last night when I went to sleep and was lying on my right hand side my left nstrl kept leaking lots of watery fluid, I had to keep going and blowing it out, this only happened when I lay on my right.. As well as this the all my teeth mainly on the top right of my jaw felt very sensitive.. But the pain subsided when I lay down.. Also my eye sockets were hurting.. So what do you reckon? ENT or neurological?

Category: Family Physician-GP

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Category: HIV- AIDS Specialist
 28 Doctors Online

Hello,
Thank you for your query at DoctorSping.com
I understand your concern.
Clear watery fluid could indicate an allergic reaction, however if it's coming out of only nostril, getting an ENT consult who can examine your sinuses will be helpful. Because sinus pains can be referred to the socket of the eye balls, and also manifest as jaw pain ( referred ).
So i advise you to get an ENT opinion.
Regards.


Patient replied :

So it wouldn't be a CSF leak or anything dangerous?


Hello,
Spontaneous CSF leak is highly rare, CSF leak secondary to injuries are possible.
But you didn't give any such history. So it can be ruled out.
Moreover CSK leak will have intense headache ( warranting an ER admission ), along with other symptoms such as severe nausea, vertigo, facial numbness, vertigo, dizziness, e.t.c
The symptoms you suggested are more pertaining to a sinus infection. In some rare cases through a minute hole in Dura, fluid can come out through the sinuses, but it actually is CSF. Even in that case there will be symptoms that i mentioned. If it is happening continuously and there is development of headache, then a CT SCAN will be required.
In absence of any symptoms, ENT opinion and local examination by the ENT specialist will be the best way to go about it.

Regards.


Patient replied :


Thanks for the response, I actually had a CT scan yesterday because I panicked and thought it was CSF.. The report was : normal intracranial appearances, no skull bone or calvarial fracture, mucosal thickening in the right maxillary antrum
This was just the unofficial report because it had not been verified by a consultant radiologist yet


Hello,
So your report confirms my analysis.
You don't have any CSF leank and the CT SCAN is normal.
Right mucosal thickening in the antrum shows sinus infection and it is better you consult ENT specialist for the same.
Regards.


Patient replied :


Yes you are correct, anyway the right mucosal thickening is something that appeared in 2012 too.. I had a septoplasty around 4 years ago and they also did a FESS on the maxillary sinus at the time so maybe the thickening is due to that?
Also the fluid leak was from the left nostril when I lay on my right.. I have a headache but just around my eyes.. The area surrounding the bridge of my nose feels tender so probably is sinusitis


Hello,
Yes pain surrounding the bridge of the nose, and headache aorund eyes are very typical for sinus infection.
The clear fluids seem to be more allergic in origin.
Before going to the ENT specialist, i will advise you take Tab. Levecetrizine for 3 days once at bed time.
If it still does not resolve you can go ahead with the ENT consult.
Regards.


Dr. Jaydeep Tripathy
Category: HIV- AIDS Specialist
Experience: 
MBBS from Sri Ramachandra University in December 2011
M.Med (Family Medicine) - TNMGR University, Chennai
MBA-MPH in Public Health in March 2016, SRM University
Finished AFIH in March 2016, SRM University
MRCP ( UK ), Internal Medicine, Royal College of Physicians, June 2016
Fellowship in Diabetology from Martin Luther University in January 2017

Currently Resident Physician, in MD Radiodiagnosis - Kamakshi Memorial Hospital, Chennai
Dr. Jaydeep Tripathy and 4 other Medical Specialists are ready to help you

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