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

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.