The management of chylous fistula following neck dissection

Abstract

Over an eleven-year period from 2001 to 2011, 471 neck dissections were performed for 352 patients. Of the 471, 18 (3.8%) patients developed chylous fistulas, 3 in the right neck and 15 in the left neck. The most common primary site was the thyroid (n = 8), followed by the larynx (n = 4), the hypopharynx (n = 3), the nasopharynx (n = 1), the tongue (n = 1), and the facial skin (n = 1). The mean maximum drain volume per day was 412ml (81~1400ml). The days to the onset were a mean of 2.2 days (1-7 days). The duration of leakage ranged from 5 to 82 days (mean 20.5 days). All 18 patients were initially managed conservatively; this was successful for 14 patients. Minocycline local injection therapy was performed on 2 patients. Surgical exploration was required on 2 patients. Three patients had local infection as complications. © 2013 Japan Society for Head and Neck Cancer.