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Ralph Metson, MD; David Alessi, MD; Thomas C. Calcaterra, MD

Arch Otolaryngol Head Neck Surg. 1986;112(6):651-653.

Abstract
• In chylous fistulas following radical neck dissections, we have found reexploration to be unrewarding, with infrequent identification of a specific leakage site intraoperatively and persistent fluid accumulation postoperatively. As an alternative, we injected tetracycline hydrochloride into the supraclavicular wound bed. This procedure resulted in a rapid, sustained decline in fistula output in two of three cases, avoiding surgical intervention. Tetracycline sclerotherapy has been described for treatment of intrathoracic and other intracavitary fluid collections. We believe that tetracycline sclerotherapy is an effective adjunct in the management of chylous fistulas following radical neck dissections and that this therapy should be attempted before surgical reexploration.

(Arch Otolaryngol Head Neck Surg 1986;112:651-653)

Author Affiliations
From the Division of Head and Neck Surgery, UCLA School of Medicine.

Footnotes
Accepted for publication Sept 4, 1985.

Read at the annual meeting of the American Society for Head and Neck Surgery, Dorado Beach, Puerto Rico, May 8, 1985.

Reprint requests to Division of Head and Neck Surgery, UCLA Center for the Health Sciences, Room 62-152, Los Angeles, CA 90024 (Dr Calcaterra).

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