A 21-year-old female underwent a routine septorhinoplasty for aesthetic and airway improvement. After envelope elevation in the sub-SMAS plane and total septal exposure through sub-perichondrial route, she underwent deviated bony and cartilaginous septal resection and caudal septal relocation, saving a sufficient L-strut. Osteotomy was internal low to low and external transverse bilaterally. Midvault reconstruction using bilateral spreader grafts was performed. Tip refinement was done by routine sutures and columellar strut graft was inserted. No tip graft was used. Overall, a routine septorhinoplasty was executed (Figure 3 and 4).
There was not any problem during postoperative period, but 4 months later, she gradually developed paroxysms of headaches followed by abundant right sided rhinorrhea. Periods of headache were felt once weekly, localized in the nasal root and right retro-ocular area and lasted about 30-45 minutes. Bilateral conjunctival injection (worse in the right side), was an accompanying symptom. All symptoms and signs aggravated gradually, eventually interfering with normal life.
At first, a list of differential diagnoses including infection, delayed retro-ocular hematoma or pseudoaneurysm, cavernous sinus thrombosis, different types of headaches and neuralgias, and intracranial pathology was arranged. Multiple studies including CT cysternography, dacrocystography, brain MRI, ophthalmologic evaluation and intraocular pressure monitoring were accomplished and all were normal. There was no problem in the routine hematologic and blood chemistry tests. Rhinorrhea liquid was examined clinically and pathologically to rule out CSF leakage that was negative. It was quite clear and non-purulent (Figure 5 and 6).
After failure to diagnose the original cause of symptoms and signs, the patient was referred to a neurologist. Motor and cranial nerve examinations were normal, with no finding in favor of central or peripheral demyelinating disorders. MRI showed no intracranial pathology. Cluster headache, trigeminal neuralgia and temporal arteritis were all ruled out. Ophthalmologic, optometric, perimetric and lacrimal system examinations were normal. There was no past medical history, except depression and anxiety, appropriately treated by sertraline, clomipramine and propranolol.
The principal distressing problem of the patient was abundant and uncontrollable runny nose. She was pain free between headache attacks, but rhinorrhea was the persistent symptom and sustained during daily activities. It was very annoying and did not respond to any kind of medical therapy including H1 blockers and local or systemic decongestants. A comprehensive review of the literature was planned. There were few papers or textbooks explaining these symptoms. Among rare complications after rhinoplasty, we encountered the Charlin`s syndrome! Literature content regarding this rare syndrome was extremely scarce. The first session of nerve block with a local anesthetic in the area around the nasal bones, confirmed the diagnosis (Figure 7). 
To treat the patient, authors decided to re-operate and explore surgically, however, the patient refused a revision surgery. So, phenol solution was used to ablate the irritating nerve ending. Symptoms and signs were alleviated but remained after two sessions of injection. Phenol was injected to the area around the nasal bones. During the third session, phenol was injected to the area beneath the nasal bones, bilaterally. Just after 2-3 weeks, patient`s pain was eradicated but rhinorrhea persisted and it took several months to stop completely.