University Clinical Health Physician Featured in Local Health Alert

Posted on July 3, 2018

University Clinical Health Physician Featured in Local Health Alert

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MEMPHIS, Tenn. ( – A Mid-South woman’s chronic runny nose ultimately had her scheduling a minimally invasive surgery. Dena Ammons is a wife and working mom to a 5-and-a-half year-old. She says last fall, she lost all her energy and couldn’t stop a constant flow of fluid from her nose.

“It was clear fluid. The headaches were so massive that laying down was the only way I could get relief,” she explains.

A trip to her primary care doctor left her on medications for allergies, but she knew quickly those weren’t the culprit, claiming “nothing worked.” It wasn’t a slow drip either, Ammons says at night, “it was all over my pillowcase. It was all over my head, the side of my face. You couldn’t sleep.”

Ammons was ultimately directed to Dr. Sangeet Ranjarajan, Assistant Professor of Otolaryngology – Head and Neck Surgery with specialized fellowship training in Rhinology and Endoscopic Skull Base Surgery for the University of Tennessee Health Science Center. He says, he knew immediately what was causing the chronic problem.

He says, “we could actually see a small little bit of pulsating brain come into the nose.” It was a Cerebrospinal Fluid (CFS) Leak. Typically, it’s caused by trauma, but in Ammons’ case there was no correlation.

“There is a minority of patients, such as Dena, who develop a spinal fluid leak through the skull base for no reason,” explains Dr. Ranjarajan. Left untreated, there could be brain herniation, which started to happen in Ammons.

Dr. Ranjarajan went to work scheduling a minimally invasive procedure to correct the problem, with an endoscopic skull base surgery. Improved technology has allowed surgeons the ability to access the leak using a camera and instruments through a natural pathway, in this case the nostril, and fix it. In the past, this would have been treated with surgery where the brain would be retracted to access the area, with far more risks involved.

“Things like Meningitis, seizures, bad infection, memory loss, sense of smell,” explains Dr. Ranjarajan.

He says, while a more rare problem, the success rate is high with endoscopic skull base surgery. For patients, side effects include stuffy nose, headaches and fatigue that subsides.

Ammons was out of work for about a month recovery following her February procedure and says it’s been life changing. “I’m able to function, I’m able to tuck my baby in at night now.”