International Journal of Phonosurgery & Laryngology

Register      Login

VOLUME 3 , ISSUE 1 ( January-June, 2013 ) > List of Articles

RESEARCH ARTICLE

Crushed Muscle Tissue Graft: A Efficient Repair Technique for Intraoperative Chylous Fistulas

Sumit Gupta, Sudhir Naik, Rajshekar Halkud, A Nanjundappa, Ashok M Shenoy, Purshottam Chavan

Citation Information : Gupta S, Naik S, Halkud R, Nanjundappa A, Shenoy AM, Chavan P. Crushed Muscle Tissue Graft: A Efficient Repair Technique for Intraoperative Chylous Fistulas. Int J Phonosurg Laryngol 2013; 3 (1):1-5.

DOI: 10.5005/jp-journals-10023-1048

Published Online: 01-06-2016

Copyright Statement:  Copyright © 2013; The Author(s).


Abstract

Background/objectives

Chylous fistula is an uncommon but serious complication of radical neck dissections and is a complication which can be better avoided than treated. Presence of amber colored lymph in the postoperative closed wound suction drainage is defined as chylous fistula.

Materials and methods

The study was done over 18 months analyzing neck dissections done for 245 cases for complications of chyle leak. Six cases of chyle leak were identified during the course of the study.

Results

All the six cases were repaired with crushed muscle tissue graft harvested from the remaining portion of the sternocleidomastoid muscle was spread out and sealed. No chyle leak complications were seen in the drains after the repair.

Conclusion

The use of crushed local muscle tissue grafts offers better chances of success for closure of chylous fistulae in the neck, especially when the fistulous opening was difficult to ligate and the site of leak was only packed with sponge gel or Surgicel®. This complication should be better avoided than repaired.

How to cite this article

Naik SM, Chavan P, Halkud R, Shenoy AM, Nanjundappa A, Gupta S. Crushed Muscle Tissue Graft: A Efficient Repair Technique for Intraoperative Chylous Fistulas. Int J Phonosurg Laryngol 2013;3(1):1-5.


PDF Share
  1. Peripheral parenteral nutrition in a case of chyle leak following neck dissection. J Hum Nutr Diet 2004; 17:153-55.
  2. Management of chyle fistulization in association with neck dissection. Otolaryngol Head Neck Surg 2000;122: 434-39.
  3. Systematic approach to the treatment of chylous leakage after neck dissection. Head Neck 1996;18:347-51.
  4. Chyle fistula management. Otolaryngol Head Neck Surg 1981;89:575-78.
  5. Management of chylous leakage following neck dissection: Cases report. J Dent Sci 2008;3(1):57-61.
  6. Chylous fistula. Arch Otolaryngol 1970;91:534-37.
  7. Management of chylous fistula using the fibrin adhesive set. Otorhinolaryngol Relat (Spec) 1998;60:230-32.
  8. Nutritional support in patients with low volume chylous fistula following radical neck dissection. J Laryngol Otol 1991;105: 1052-56.
  9. Postoperative chylous fistula prevention and management. Laryngoscope 1976;86:804-13.
  10. Objective and early diagnosis of chylous fistula in the postoperative period. Otolaryngol Head Neck Surg 2002;126:172-75.
  11. Management of chylous fistula. Laryngoscope 1975;85:835-40.
  12. The management of chyle fistula. Laryngoscope 1990;100:771-74.
  13. Cervical lymph node metastasis. Curr Probl Surg 1993;30:1-335.
  14. Systematic management of chyle fistula: The Southwestern experience and review of the literature. Otolaryngol Head Neck Surg 2000;122:31-38.
  15. Thoracic duct injuries. South Med J 1977;70:1062-63.
  16. VATS thoracic-duct division for aortic surgery-related chylous leakage. Eur J Cardiothorac Surg 2005;27:153-55.
  17. Results of mandatory exploration for penetrating neck trauma. World J Surg 1994;18:917-19.
  18. Bilateral chylothorax complicating radical neck dissection: Report of a case with no concurrent external chylous leakage. Head Neck Surg 1985;7:225-30.
  19. Prevention of complications in neck dissection. Head Neck Oncol 2009;1:35.
  20. Case report: Chylous fistula following right radical neck dissection. Can J Otolaryngol 1975;l4:177-79.
  21. Anatomical variations of the cervical portion of the thoracic duct in man. J Anat 1973;115:45-52.
  22. Repair of a high-output chylous fistula with a free fat graft. Laryngoscope 1998;108:938-40.
  23. Chyle leaks: Consensus on management? Nutr Clin Pract 2008;23(5):529-32.
  24. Management of chyle fistulae following surgery in the neck. Indian J Cancer 2001;38: 117-20.
  25. Is dissection of level IV absolutely necessary in elective lateral neck dissection for clinically no laryngeal carcinoma? Oral Oncol 2006;42:102-07.
  26. Carotid artery protection with levator scapulae muscle. Arch Otolaryngol 1966;84:198-200.
  27. A muscle cover for the carotid artery after radical neck dissection. Am J Surg 1961;102:815-17.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.