Rhinorrhea (also known as Runny nose) refers to a case when the nasal cavity is filled with large amount of fluids. It is the second common nasal symptom. It may be anterior or passes back as postnasal discharge. It may be unilateral or bilateral.
Types of Nasal discharge:
- Mucoid: Secondary to nasal obstruction due to stasis.
- Mucopurulent: from infection on top of stagnant mucus (the same causes).
- Bloody: discussed under the title of epistaxis.
- Crusty: Usually offensive.
- Fluids and food: nasal regurgitation.
Causes of unilateral nasal discharge
- Watery| CSF rhinorrhea: increases by straining & leaning forward, diagnosed by CT & MR.
- Crusty| unilateral atrophic rhinitis e.g. total turbinectomy.
- Fluids & food| Oroantral fistula: Offensive.
Causes of bilateral nasal discharge
- Excessive lacrimation
- Allergic & vasomotor rhinitis
- Hyperemic stage of acute rhinitis
- Atrophic rhinitis
- Nasal Granuloma
Fluids & food:
- Cleft palate.
- Paralyzed soft palate e.g. bulbar palsy.
- Shortening of soft palate due to trauma or fibrosis.
- Perforated hard palate e.g. granuloma and maxillectomy.
- Unilateral offensive rhinorrhea in a child is highly suggestive of neglected F.B.
- Unilateral watery rhinorrhea that increases by leaning forward should be investigated thoroughly as it may be CSF.
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