Gustatory rhinorrhea--a complication of septoplasty.
A previously unreported complication of septoplasty, which is the profuse flow of thin clear nasal drainage on mastication, is described. Of a combined group of 1332 patients with septoplasty and septorhinoplasty, 6 females and 1 male presented with gustatory rhinorrhea after surgery. The average age of the patients who experienced this complication was 44.43 years. Three patients tested the efficacy of antihistamines, which proved helpful in reducing the severity of this condition. The cause of gustatory rhinorrhea is postulated as inadvertent injury to the nasopalatine nerve within the septal layers after removal of the deviated portion of the vomer and the perpendicular plate of the ethmoid bone during septoplasty. It is the authors' supposition that regenerating nerve sprouts are inappropriately directed toward nasal, rather than palatal, target receptors. Consequently, rhinorrhea results while eating. The pathophysiology of this new finding is not dissimilar to gustatory sweating after parotidectomy. Although this complication is not life-threatening, it is socially disturbing to patients. The authors believe that awareness of this sequela will lead to the discovery of a larger patient population and a potential treatment or prevention.
Guyuron
B
B
Department of Surgery, Case Western Reserve University, Cleveland, Ohio.
Michelow
B
B
Thomas
T
T
D000328:Adult; D017776:Autonomic Pathways / Q000293:injuries* / Q000502:physiology; D004435:Eating / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008409:Mastication / Q000502:physiology*; D009093:Mucus / Q000378:metabolism; D009297:Nasal Mucosa / Q000294:innervation / Q000378:metabolism*; D009300:Nasal Septum / Q000601:surgery*; D009416:Nerve Regeneration / Q000502:physiology; D010159:Palate / Q000294:innervation; D012225:Rhinoplasty / Q000009:adverse effects*