Novel Management of Intractable Cervical Chylous Fistula with Local Application of Pseudomonas aeruginosa Injection.

OBJECTIVE: Cervical chylous fistula is an uncommon complication after neck dissection, but it might lead to some serious clinical outcomes. Although most cervical chylous fistulas can heal in a few days with standard treatments, some can be intractable. In this study, we describe a new method with local application of Pseudomonas aeruginosa injection for intractable cervical chylous fistula.

STUDY DESIGN: Case series with chart review.

SETTING: West China Hospital, Sichuan University, Chengdu, China.

SUBJECTS AND METHODS: The charts of 18 patients who were treated with P aeruginosa injection (PAI) for intractable cervical chylous fistula were retrospectively reviewed.

RESULTS: All patients were successfully treated with PAI. Mild fever (temperature, <38°C) occurred in 9 patients, moderate fever (38°C-39°C) in 4 patients, and severe fever (>39°C) in 5 patients. All patients had mild to severe neck pain.

CONCLUSIONS: Local application of PAI is an effective method for the treatment of intractable cervical chylous fistula, of which the most common side effects are transient fever and local pain.