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Left-sided neck dissection and chylothorax: a rare complication and its management

  • V Prabhu (a1) and C Passant (a1)

Abstract

Objective:

We present a case of bilateral chylothorax, a rare but life-threatening complication, which developed following a left-sided neck dissection.

Method:

Case report and literature review.

Results:

Chylous leakage fistula is a known complication following neck dissection and occurs in 1 to 2 per cent of patients. After left-sided neck dissection, chylothorax is uncommon and bilateral chylothorax is even rarer. Chylothorax is encountered following certain thoracic procedures, especially superior mediastinal dissection for thyroid cancer treatment. We discuss in detail the successful management of a complicated case.

Conclusion:

We discuss various management options for this condition, and we summarise its successful management within our department.

Copyright

Corresponding author

Address for correspondence: Mr Vinod Prabhu, Speciality Trainee, Department of ENT, ‘E’ Block, Royal Gwent Hospital, Newport NP20 2UB, Wales, UK Fax: +44 (0)1633 257 191 E-mail: hvinodprabhu@hotmail.com

References

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1Spiro, JD, Spiro, RH, Strong, EW. The management of chyle fistula. Laryngoscope 1990;100:771–4
2Jabbar, AS, Al-Abdulkareem, A. Bilateral chylothorax following neck dissection. Head Neck 1995;17:6972
3Stuart, WJ. Operative injury of the thoracic duct in the neck. Edinb Med Journal 1907;22:301–6
4Tsukahara, K, Kawabata, K, Mitani, H, Yoshimoto, S, Sugitani, I, Yonekawa, H et al. Three cases of bilateral chylothorax developing after neck dissection. Auris Nasus Larynx 2007;34:573–6
5Weider, WA, Steiner, RM. Roentgenographic demonstration of intra-pulmonary and pleural lymphatics during lymphangiography. Radiology 1971;100:533–9
6Crumley, RL, Smith, JD. Postoperative chylous fistula prevention and management. Laryngoscope 1976;86:804–13
7Srikumar, S, Newton, JR, Westin, TA. Bilateral chylothorax following left-side radical neck dissection. J Laryngol Otol 2006;120:705–7
8Ng, RS, Kerbavaz, RJ, Hilsinger, RL Jr.Bilateral chylothorax from radical neck dissection. Otolaryngol Head Neck Surg 1985;93:814–17
9Kalomenidis, I. Octreotide and chylothorax. Curr Opin Pulm Med 2006;12:264–7
10Selle, JG, Snyder, WH 3rd, Schreiber, JT. Chylothorax: indications for surgery. Ann Surg 1973;110:245–9

Keywords

Left-sided neck dissection and chylothorax: a rare complication and its management

  • V Prabhu (a1) and C Passant (a1)

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