Postoperative chylous fistula prevention and management

Postoperative chylous fistulas occur as a complication in 1–2 percent of all radical neck dissections. Twelve cases are reviewed herein. Chylous fistulas are more common with left neck dissections, but 25 percent occurred on the right side in this series. An intraoperative chylous fistula was recognized and treated in 75 percent of the cases which later developed a postoperative fistula. Postoperative fistulas may be divided into two groups: minor fistulas may be treated with pressure dressings and repeated aspirations; fistulas which do not respond to conservative management should be re‐explored early and the fistula ligated.