Persistent chyle leak following radical neck dissection: a solution that can be the solution

Muthusami, John C.; Raj, John P.; Gladwin, D; Gaikwad, Pranay; Sylvester, Shalom

doi:10.1308/1478708051766

Cited by 15 publications

(9 citation statements)

References 3 publications

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“…Cyanoacrylate adhesives, fibrin glue [ 63 – 65 ], and polyglactin (Vicryl) mesh [ 64 ] have been placed at the time of surgery, with success, for controlling visible CL.…”

Section: Treatment Options For Chyle Leaksmentioning

confidence: 99%

Management of Chyle Leak after Head and Neck Surgery: Review of Current Treatment Strategies

Delaney

Shi

Shokrani

et al. 2017

International Journal of Otolaryngology

119

147

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Chyle leak formation is an uncommon but serious sequela of head and neck surgery when the thoracic duct is inadvertently injured, particularly with the resection of malignancy low in the neck. The thoracic duct is the primary structure that returns lymph and chyle from the entire left and right lower half of the body. Chyle extravasation can result in delayed wound healing, dehydration, malnutrition, electrolyte disturbances, and immunosuppression. Prompt identification and treatment of a chyle leak are essential for optimal surgical outcome. In this article we will review the current treatment options for iatrogenic cervical chyle leaks.

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“…Cyanoacrylate adhesives, fibrin glue [ 63 – 65 ], and polyglactin (Vicryl) mesh [ 64 ] have been placed at the time of surgery, with success, for controlling visible CL.…”

Section: Treatment Options For Chyle Leaksmentioning

confidence: 99%

Management of Chyle Leak after Head and Neck Surgery: Review of Current Treatment Strategies

Delaney

Shi

Shokrani

et al. 2017

International Journal of Otolaryngology

119

147

View full text Add to dashboard Cite

show abstract

“…Modification of enteral nutrition involves a fat-free or low-fat diet supplemented with medium-chain triglyceride oil. A somatostatin analog could be used because it decreases the absorption of triglycerides [6]. A persistent leak necessitates neck exploration and ligation of the lymphatic(s), occasionally requiring muscle flap coverage.…”

Section: Discussionmentioning

confidence: 99%

“…Currently, n-butyl-2-cyanoacrylate (NBCA), a solution that can be used to prevent chyle leakage, meets all requirements described in ISO (International Organization for Standardization) 10993 for internal use [4]. Promising results have recently been reported by investigators who used NBCA to treat chyle leakage [25678].…”

Section: Introductionmentioning

confidence: 99%

Biocompatibility of n-butyl-2-cyanoacrylate (Histoacryl) in cervical structures of rats: prospective in vivo study

Suh

Kim

et al. 2019

Ann Surg Treat Res

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Purpose We investigated the biocompatibility of n-butyl-2-cyanoacrylate (NBCA) in the cervical deep tissues of rats to assess its biocompatibility. Methods A total of 30 Sprague-Dawley rats were injected with NBCA. After 30, 90, 180, and 360 days, cubes of tissue (1 cm × 1 cm × 1 cm) surrounding the NBCA and normal tissue from the other side of the neck were excised from each rat. The adhesion of NBCA to adjacent structures was examined histologically. Cells were counted per high-power field (HPF), and fibrosis was graded with the measurement of fibrotic thickening. Results All animals displayed normal behavior without any symptoms of distress throughout the study. There was no recognizable inflammatory reaction, foreign body reaction, or fibrosis in the 30 control samples. The analyses of experimental samples showed significantly decreased inflammatory cell counts over time (lymphoplasma cell count decreased from 100 (range, 70–100) to 30 (range, 30–50) per HPF, P = 0.010; neutrophil count decreased from 2 (range, 2–30) to 0 (range, 0–2) per HPF, P = 0.017). However, there was no significant difference in the number of multinuclear giant cells throughout the study period (a decrease from 22 [range, 16–34] to 16 [range, 12–22] per HPF, P = 0.287). The level of fibrosis was Common Toxicity Criteria ver. 4.0 Grade 1 without further thickening (P = 0.600). However, maturation of fibrosis progressed gradually. Conclusion NBCA was biologically tolerable in the cervical deep tissues of rats. However, precautions are needed with respect to preventing a sustained foreign body reaction and fibrosis.

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“…Suture needles should not be placed directly through the duct as it is fragile in nature and has multiple thin‐walled branches . Therefore, rotation of the local muscle flap, use of a sclerosing agent, such as tetracycline, and use of fibrin glue or cyanoacrylate glue are recommended as adjunct techniques to direct suturing.…”

Section: Discussionmentioning

confidence: 99%

Therapeutic role of ultrasound-guided intranodal lymphangiography in refractory cervical chylous leakage after neck dissection: Report of a case and review of the literature

Chen

Shiau

et al. 2015

Head Neck

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Persistent chyle leak following radical neck dissection: a solution that can be the solution

Abstract: A case report of a chyle leak following radical neck dissection for residual lymph nodal disease performed after chemoradiation for nasopharyngeal carcinoma. This is the first case report of the use of cyanoacrylate for a persistent chyle leak following radical neck dissection.

Cited by 15 publications

References 3 publications

Management of Chyle Leak after Head and Neck Surgery: Review of Current Treatment Strategies

Management of Chyle Leak after Head and Neck Surgery: Review of Current Treatment Strategies

Biocompatibility of n-butyl-2-cyanoacrylate (Histoacryl) in cervical structures of rats: prospective in vivo study

Therapeutic role of ultrasound-guided intranodal lymphangiography in refractory cervical chylous leakage after neck dissection: Report of a case and review of the literature

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