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Post-traumatic prandial rhinorrhea.

N Scher1, D S Poe

  • 1University of Chicago Medical Center, Otolaryngology, Head and Neck Surgery, Chicago, IL 60637.

Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons
|January 1, 1988
PubMed
Summary
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A rare case of clear, mealtime-triggered nasal drainage (rhinorrhea) occurred after a LeFort III fracture. This was caused by a salivary leak from the parotid gland into the sinus, which was surgically fixed.

Area of Science:

  • Maxillofacial surgery
  • Otorhinolaryngology
  • Neurosurgery

Background:

  • LeFort III fractures, complex midface injuries, can lead to rare late complications.
  • Post-traumatic rhinorrhea, or nasal drainage, typically suggests cerebrospinal fluid leak but can have other origins.

Observation:

  • A patient presented with clear rhinorrhea exclusively during meals, months after a LeFort III fracture.
  • Diagnostic imaging revealed an unusual parotid-antral communication, a direct connection between the salivary gland and the maxillary sinus.

Findings:

  • Surgical exploration confirmed the parotid-antral fistula as the source of the rhinorrhea.
  • This represents only the second reported case of parotid-antral rhinorrhea in medical literature.

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Implications:

  • Salivary fistulas should be considered in the differential diagnosis of post-traumatic rhinorrhea, especially when symptoms are linked to eating.
  • Prompt surgical correction can resolve this rare but bothersome complication, improving patient quality of life.