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CION Cancer Clinics
Nasal regurgitation: food and liquids coming through the nose after maxillectomy | CION Cancer Clinics
Food and drink come through the nose after a maxillectomy because the roof of the mouth has been opened into the nose and the plate or flap is not yet sealing it fully. In the first weeks this is expected. This page explains the five causes, what to do when it happens at a meal, which kind of leakage needs a same-day call, and how each cause is put right. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
MI
Medically reviewed by Dr. Mohammed ImaduddinConsultant Surgical Oncologist · MBBS, MS (General Surgery), MCh (Surgical Oncology) · last reviewed September 2026, next review due September 2027
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On this page
- Why is food coming through my nose after surgery?
- The five reasons it usually happens
- What to do when it happens during a meal
- Leakage that is part of healing, and leakage that is not
- Four things families say about food in the nose
- What fixes it, and what this page cannot tell you
- Common questions about food coming through the nose
The short answer
Why is food coming through my nose after surgery?
Food and drink come through the nose after a maxillectomy because the roof of the mouth has been opened into the nose, and whatever seals that opening is not yet sealing it fully. In the first weeks this is expected. If it is new, getting worse, or happening months later, the seal needs checking.
What is actually happening
The maxilla is the upper jaw. It forms the hard palate, the bony roof of your mouth, which normally keeps the mouth and nose apart. When part of it is removed for cancer, there is a direct opening between the two. Swallowing pushes food backwards and upwards as well as down. Anything that reaches that opening goes into the nose. Liquids find it first, then soft food, then crumbs.
What is meant to stop it
Either an obturator, a removable plate that covers the opening, or a flap, living tissue moved into the gap during surgery. Both work by closing the route. Both can leak: a plate because it does not fit the changing cavity, a flap because a small gap has opened at its edge. The cause decides the fix, which is why the team wants to see it rather than hear about it.
The medical term you may read is nasal regurgitation. It simply means food or liquid coming back up into the nose.Finding the cause
The five reasons it usually happens
Your surgeon or prosthodontist will look for one of these. Knowing which it is tells you how quickly it can be put right.
No seal yet
In the first days, before a plate is fitted or while the flap is swollen, there is simply an open route. This is why you start on a feeding tube and then on sips. It passes.
The plate no longer fits
The cavity shrinks as it heals, so a plate that sealed well last month can leak this month. Swelling going down, teeth being removed and weight loss all change the fit.
Clues
- The plate rocks or lifts when you chew
- Leakage slowly increasing over weeks
A gap at the edge of a flap
Flap tissue is stitched to the edge of the palate. If one part of the join heals slowly, a small opening called a fistula forms. It often shows up as leakage beginning a week or two after surgery, not on day one.
The soft palate is not moving
The soft palate at the back lifts to close the nose during swallowing. If it was part of what was removed, or if its nerves are bruised, it cannot close. A plate can be extended backwards to help with this.
Something new in the cavity
Rarely, leakage that starts months later comes from a change in the cavity itself: infection, a bony spur, or regrowth. This is why late or worsening leakage is always examined, not just relined.
Not sure whether this applies to you?
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What to do when it happens during a meal
Stop and lean forward
Put the spoon down, sit upright and drop your chin. Leaning forward lets what is in the nose drain out the front rather than into the throat. Have a tissue ready and do not be embarrassed.
Clear the nose gently
Let it run out, then blow very gently with the mouth open. Blowing hard forces air and food into the sinus and the wound. If your surgeon has told you not to blow your nose at all, sniff and spit instead.
Rinse the mouth and the nose
A mouthful of plain or salt water, swished and spat out, clears the cavity. If your team has given you a nasal saline spray or rinse, use it after meals too.
Change the texture and carry on
Move to something thicker for the rest of that meal. Curd, thick dal or mashed rice go down more easily than water or rasam. Small spoonfuls, placed on the unoperated side.
Expected, or call us
Leakage that is part of healing, and leakage that is not
Usually part of healing
Call the helpline the same day
Expected: thin liquids leaking in the first weeks, slowly improving
Call: leakage that was improving and is now getting worse
Expected: a little leakage when the plate is out for cleaning
Call: leakage with a bad smell, new pain or bleeding from the cavity
Expected: more leakage for a day or two after a plate is adjusted
Call: leakage plus coughing fits, a wet voice or breathlessness at meals
Expected: food occasionally trapped under the plate that rinses away
Call: leakage that begins for the first time months after surgery
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Commonly believed
Four things families say about food in the nose
"The operation has failed."
Leakage in the early weeks says nothing about whether the cancer was removed. The cancer part of the operation and the seal are separate jobs. The seal is adjusted many times as the mouth heals, and adjusting it is routine, not a sign that something went wrong.
"If we stick to water and juice it will be safer."
Thin liquids leak the most, because they run through any gap. Thick, moist foods are easier to control and give far more nourishment. Staying on liquids usually means losing weight, which slows the very healing that will close the gap.
"Taking the plate out at meals will stop food getting stuck under it."
Without the plate there is nothing between the mouth and the nose, so far more will leak. Keep it in to eat, then take it out to clean it and rinse the cavity. If food is packing under it, the fit needs adjusting, which is a quick job for the prosthodontist.
"He should just blow his nose hard and clear it."
Hard blowing pushes food and air into the sinus and against the healing edges. It can open a small gap into a bigger one. Lean forward, let it drain, blow gently with the mouth open, and rinse. Ask your surgeon when normal nose-blowing is safe again.
Being straight with you
What fixes it, and what this page cannot tell you
Most leakage is fixed in the prosthodontist's chair. The plate is relined with soft material to match the cavity as it is today, or extended backwards to help the soft palate. This can be done many times and usually takes one visit. A new plate is made when the cavity has stopped changing shape.
When a flap edge has opened
A small gap at the edge of a flap sometimes closes on its own with rinsing and time. If it does not, a small plate can cover it, or the surgeon can stitch it again once the tissue is healthy. Larger gaps may need a second, smaller flap. Your surgeon will say which applies to you after looking, and radiotherapy timing can affect the choice.
What this page cannot tell you
It cannot tell you which of the five causes is yours, and therefore how quickly it will be put right. That needs someone to look into the cavity with the plate out. It also cannot tell you whether late leakage is anything to do with the cancer. Usually it is not, but the only way to know is to be examined, so do not wait for the next scheduled review to mention it.
Bring the plate, and if you can, a note of which foods leak and which do not. It shortens the visit.Questions we are asked
Common questions about food coming through the nose
How long will food keep coming through my nose?
For most people it is worst in the first weeks and improves each time the plate is refitted or as the flap settles. Some leakage with thin liquids can continue for months. Leakage that is steady or improving is expected. Leakage that is getting worse needs the seal checked rather than more time.
Is it dangerous if food goes into the nose?
Going into the nose is unpleasant but not dangerous in itself. It becomes a problem if food stays in the cavity and causes infection, or if the same weak swallow also lets food into the windpipe. Coughing, a wet voice or breathlessness at meals is the sign to call about.
Will it happen with every food?
No. Thin liquids leak most, then runny foods like rasam and thin sambar, then crumbs. Thick and moist foods such as curd rice, khichdi or soft idli in sambar usually stay where they should. Keeping a short note of what leaks helps the prosthodontist see where the gap is.
Why did it start again after weeks of being fine?
Usually because the cavity has changed shape and the plate no longer matches it. A tooth removed, swelling going down or weight loss can all do this. Occasionally it is a small opening at the edge of a flap. Either way, it is examined and usually fixed with a reline or a small repair.
Can I use a nasal spray or steam?
Saline spray or a gentle saline rinse is commonly advised and helps clear food and crusts. Check with your surgeon before using anything else, including decongestant sprays or steam inhalation, because the healing edges are easily irritated. Do not put anything into the cavity yourself.
Does leaking mean the plate was made badly?
Almost never. A plate is made to fit a cavity that is still changing, so it goes out of date rather than being wrong. Several refits are part of the plan. If the plate has never sealed at all, say so, because that is a different problem and may need a new impression.
Will a flap stop it completely?
A well-healed flap closes the route, so leakage usually stops. It can return if a gap opens at the edge or if the soft palate does not move well. Some people with a flap still use a small plate for the back of the palate. Ask your surgeon what to expect from your own reconstruction.
Who do I contact: the surgeon or the dentist?
Either, and they talk to each other. If the plate is rocking or leaking, the prosthodontist is the usual first call. If there is pain, bleeding, smell or leakage with a flap, contact the surgical team. If unsure, call the helpline.
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Sources
- Cancer Research UK — Surgery for mouth cancer
- American Cancer Society — Surgery for Nasal Cavity and Paranasal Sinus Cancer
- Macmillan Cancer Support — Eating problems and cancer
- National Cancer Institute — Paranasal Sinus and Nasal Cavity Cancer Treatment (PDQ) - Patient Version
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Eating and Drinking After MaxillectomyThe full path from feeding tube back to normal mealsObturators: The Removable Plate That Seals the PalateHow the plate is made, relined and replacedNose and Sinus Care After MaxillectomyRinsing, crusting and when nose-blowing is safeFlap Reconstruction vs ObturatorWhy the two seals leak for different reasonsComplications and Red FlagsThe signs after any operation that need a same-day call
Talk to us
Food leaking into the nose and not sure if it is normal?
Call the helpline. A surgical oncologist can tell you whether what you are describing is part of healing, and arrange a prosthodontist or surgical review if it is not. One helpline serves every CION centre.