Management of chyle fistulization in association with neck dissection

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dc.contributor.authorGregor R.T.
dc.date.accessioned2011-05-15T16:17:35Z
dc.date.available2011-05-15T16:17:35Z
dc.date.issued2000
dc.description.abstractChylous fistula after neck dissection is a relatively rare but potentially lethal complication. Sequelae range from severe fluid, electrolyte, and protein loss to fistula formation, skin-flap necrosis, and carotid blowout. A thorough knowledge of the anatomy is essential to avoid injury to the thoracic duct or right lymph duct. After surgery, drainage of large amounts of fluid, particularly if milky, may alert the surgeon to the danger of chylous leakage. Certain diagnosis, however, is not so easy. Once the diagnosis is made, the management has to address the immediate and late effects of the loss of chyle into an operative site. This article seeks to examine these factors through review of the literature and personal experience with the problem. Total parenteral nutrition allows for control of the fluid and protein loss while avoiding flow of chyle, and in most cases it results in resolution. In those cases that do not resolve, fibrin glue with some type of mesh and muscle flaps usually succeed in closure.
dc.description.versionArticle
dc.identifier.citationOtolaryngology - Head and Neck Surgery
dc.identifier.citation122
dc.identifier.citation3
dc.identifier.issn01945998
dc.identifier.urihttp://hdl.handle.net/10019.1/14280
dc.subjectfibrin glue
dc.subjectadult
dc.subjectaged
dc.subjectarticle
dc.subjectchyle
dc.subjectclinical article
dc.subjectclinical feature
dc.subjectdiagnostic approach route
dc.subjectfistula
dc.subjecthead and neck carcinoma
dc.subjecthuman
dc.subjectmale
dc.subjectmuscle flap
dc.subjectneck dissection
dc.subjectreoperation
dc.subjectsurgical anatomy
dc.subjectsurgical equipment
dc.subjectsurgical technique
dc.subjecttotal parenteral nutrition
dc.subjectAdult
dc.subjectAged
dc.subjectChyle
dc.subjectCutaneous Fistula
dc.subjectHumans
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectNeck Dissection
dc.subjectNeoplasm Staging
dc.subjectOtorhinolaryngologic Neoplasms
dc.subjectPostoperative Complications
dc.subjectReoperation
dc.subjectThoracic Duct
dc.titleManagement of chyle fistulization in association with neck dissection
dc.typeArticle
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