Rhinorrhea

 Inflammatory
-Allergic rhinitis will have dear mucoid rhinorrhea, which can be watery
and thin. or also somewhat sticky and tenacious, but always dear. It is
associated with nasal congestion, sneezing, itchy nose and eyes, and
epiphora. Other symptoms of generalized allergy are generalized pruritis,
itchy ears, and dark circles under the eyes. On nasal examination,
typical findings include edematous mucosa throughout the nasal cavities
bilaterally; pale, bluish, hypertrophic turbinates; dear, thin, mu134
Differential Diagnosis in Otolaryngology
coid nasal drainage; and hyperreactive mucosa associated with sneezing
during endoscopy.
 Infectious

- Viral rhinitis and sinusitis usually cause clear, thin, mucoid nasal rhinorrhea.
Bacterial rhinitis and rhinosinusitis usually cause thick, purulent
rhinorrhea
 Autonomic
- Vasomotor rhinitis is associated with clear, mucoid rhinorrhea in the
absence of inhalant allergies. Rhinorrhea can be exacerbated by exercise,
cold temperatures, or eating.

Beta-2 transferrin

Beta-2 transferrin is a protein found in CSF and the aqueous and vitreous
humor of the eye. Nasal fluid is collected and sent for laboratory examination.
Electrophoresis is performed to separate proteins and detect beta-2
transferrin. When present, CSF leak is confirmed; however, a negative
test result does not exclude the diagnosis of CSF leak.

Tips

The mucous blanket
o The nasal cavity produces 1 to 2 L of mucus per day.
o Mucus is highly acidic (pH- 6.0) and contains:
-Water
-1-2%salts
- 2-3% glycoproteins
-Immunoglobulins
o Mter secretion, mucus forms a bilayer consisting of a thicker, more viscous
gel layer on the surface. This overlies the more serous sol layer.
o Mucus is swept from posterior to cmterior by cilia toward the nasal
vestibule.