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Brain/Pituitary Tumors Community
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Avatar universal

Nasal discharge (CSF?) post transphenoidal surgery for pituitary tumor?

Hi, I had endoscopic transphenoidal surgery performed to remove a pituitary macro-adenoma on 11/29/10. The surgeons (ENT and Neuro) say the surgery went very well and they did not see or suspect a CSF leak. I had a LOT of bloody discharge after the surgery for close to two weeks, which the surgeons assured me was normal. Headaches went away a week after surgery but resumed, along with nose pain, after I started to sneeze about two weeks after surgery. I'm now almost three weeks out and sneeze (cannot stop it, no matter how much I try) 2-3 times a day. This causes pain in my nose, a slight headache, which tylenol relieves, and I continue to have nasal discharge but now it's not bloody, it's clear. There's no post nasal drip, no salty or metallic aftertaste, the headaches are much better and infrequent, I feel fine standing up and lying down, and the discharge is not constant but has me worried. I saw my ENT a week after surgery and he wasn't concerned. I will see him in three days again (three weeks post surgery). I think I just caught a cold - hence the sneezing, but I wanted to get others' thoughts as well. What do you think?

For those of you who had surgery through the nose, waht was your recovery like?

Thank you!
Lana
18 Responses
Avatar universal
COMMUNITY LEADER
Ah... every one has to sneeze - but to take the "pressure off", open your mouth so it diffuses what comes out your nose and then it will not hurt your surgical site so much. It can be a bit more messy (keep tissues around) but it will hurt your head less!

I had a problem with drip and it lasted a bit long - and we have a person here with a CSF leak. I developed an infection post-op and if you had that, you will know it by the smell which you cannot escape. Not having a huge headache is a good sign that it is not a leak.

Did you have any scabs come out? That sometimes come out - they can be large, fall out and go down the throat if you don't spit them out.

Does coffee help?
Avatar universal
Hi, I did have many scabs but they are less frequent. You mentioned you had a drip for a while. What was it like? Clear? From both or one nostrils? Did you have the salty taste in the back of your mouth? The residents at the hospital made me completely paranoid about having a CSF leak while both my surgeons said I was perfectly fine.

I definitely don't have a headache but do have a little bit of a smell, but I've had that from the very beginning.

I haven't tried coffee. I feel like I just have a runny nose from a cold (hence the sneezing) but don't know how to tell for sure and am getting very panicky.
Avatar universal
COMMUNITY LEADER
Mine was clear. I could not tell where it was coming from I had to wear gauze on my nose to prevent it from just dripping down my face... not fun. Ah the memories....

If you know someone with a glucometer - you can test the fluid - snot has no glucose, CSF does. Plus CSF does make different patterns on a coffee filter - rings - while mucus does not.

Caffeine is an old treatment for the leaks - as well as lying flat.
Avatar universal
Wow! That sounds like a lot of fluid! So glad it wasn't CSF. How did they explain it?

I don't know anyone who has a glucometer but will try to get in to see the ENT a little earlier. This uncertainty is killing me!

THanks,
Svetlana
Avatar universal
COMMUNITY LEADER
Actually, it was CSF, It just took a while to stop post op... but I stopped on my own - most people do.

Be glad you don't have the headache, take care - and rest up - you are probably still healing.
Avatar universal
It's fantastic that it stopped. How long did it take? Were you on bedrest or just taking it easy to help the leak stop on its own? Did doctors recommend any kind of intervention - lumbar spine drain or endoscopic surgery to close the leak?

Thank you!
Avatar universal
COMMUNITY LEADER
Mine stopped after a few days after the hospital - my surgeon stayed on top of it. It went longer than it was supposed too and there was a medication to take but I could not get it and it stopped on its own. I did lay flat. I did not require surgery so I don't really consider mine much of a leak.
Avatar universal
Oh, so your leak only took place in the hospital. Was it clear or bloody?
Avatar universal
Did your surgeon suspect a CSF leak during the surgery?

If it stopped on its own, how do you know it was a leak as opposed to normal discharge? I had varying discharge, always bloody, while I was at the hospital and then for a week at home, but it was rarely as heavy as you described. The discharge is now clear and a very very slow trickle, only at certain times of the day/during certain activities.

Thanks!
Avatar universal
COMMUNITY LEADER
Mine was clear. A leak was not suspected. It just did not stop after surgery and I had to keep wearing the gauze and the doc had me lay flat etc. and finally it cleared up. I would have taken the meds but the pharmacy people were all messed up with my insurance so I did not get it in time and then I did not need it! It was not fast - It was just persistent so I had to have something on my face as it was there or it would drip down my face.
Avatar universal
I just noticed this thread - pardon my late entry!

I had the same surgery just this April, for a non-functional pituitary macroadenoma.  I had no CSF leaks, but I did get a post-op sinus infection.  That was cleaered with antibiotics, but now, while I have no sinus pain or headaches, my sinuses feel "full" and about every 2-4 days I get a bad smell in my nose and a large semi-solid, messy green discharge.  Once it's gone I do feel better, but after a couple of days it happens again.  I will be seeing my neurosurtgeon again in about a month, but does anyone have any ideas?  
985561 tn?1255203960
Hi Lana, this is Angelo from Athens Greece, I had an endoscopic surgery 3 years ago to remove a pituitary adenoma and they went in from my upper lip, I guss it pased from the nose also.
I was wearing gauze in my noze for a week to prevent dripping, then when I removed it was driping when looking down something that I was trying not to do, it was bloody in the beginig and and then after 2-3 days clear.
The neurosurtgeon asked me if a have a strange taste in my mouth and I told him no.
As far as the upper lip I could not feel it for more than 6-8 months, even my front upper teeth I could not feel them for more than a year.
As for the headaches, after two days from the surgery they disapear and the fany thing is that since then I dont have any headaches at all no mater what I do, hahaha I lost the headache feeling.
So dont worry the driping will stop,try not to look down.
Take care.
Angelo
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