Chylous leakage is not an uncommon complication after neck dissection. It occurs in 1-2.5% of neck dissection, with majority (75-92%) on the left side. There is currently no recognized surgical algorithm for the treatment of chyle leak in the neck. Conservative treatment protocols have been established and include closed vacuum drainage, nutrition modification and somatostatin analog. We present a case of right sided chyle leak treated successfully with a sternocleidomastoid muscle flap and TP3. A 57 year old female with SCC was treated with right sided partial glossectomy, mandibulotomy, unilateral selective neck dissection and radial forearm free flap reconstruction. A right sides neck swelling was noted 12 days post operatively. Surgical exploration and a right sided chylous leak was found but there was no obvious source of leakage. TP3 was used in conjunction to a sternocleidomastoid muscle flap to help tissue adhesion. The leak was treated through this surgical approach with dietary modification without compromising the viability of her original free flap. The use of TP3 forms to form an air/blood and fluid tight barrier can assist the muscle flap in containing a chylous leak. TP3 should be an adjunct in the treatment of such conditions.
Should TP3 form part of the surgical algorithm for treatment of chyle leaks in the neck?
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