US-guided catheter drainage of postoperative head and neck fluid collections.
OBJECTIVE
To analyze results of percutaneous catheter drainage of large fluid collections in the head and neck region noted in the immediate postoperative period.


METHODS
Thirty-four consecutive patients with 41 large fluid collections in the head and neck detected 7-10 days after oncologic surgery underwent percutaneous catheter drainage. There were 29 men and five women, with a mean age of 52.2 years (95% CI: 47.8-56.7). Each patient had a surgical drain placed in the posterior neck triangle; three patients had low-grade fever and six had diabetes at the time of percutaneous catheter drainage. Conventional management consisting of serial needle aspirations at bedside followed by pressure dressing failed in 15 of 34 patients (44%). Ultrasound-guided drainage was performed and catheters were connected to vacuum balls for continuous suction drainage.


RESULTS
The average fluid volume estimated by sonographic measurement was 84 cm(3) (95% CI: 57-112 cm(3)). The fluid content was serosanguinous in 46% (19 of 41), uncoagulated blood in 32% (13 of 41), pus in 15% (six of 41), and saliva in 7% (three of 41). The mean duration of catheter drainage was nine days (95% CI: 7-10 d) and mean fluid drainage was 287 mL (95% CI: 188-387 mL). Ninety-one percent of patients (31 of 34) were successfully treated with initial catheter drainage. Three patients had recurrent fluid collections at the same locations: two were treated with repeated catheter insertions and one required a limited open drainage. No complication related to catheter drainage was noted at 6-month follow-up.


CONCLUSIONS
Percutaneous catheter drainage is effective for large fluid collections in the head and neck region noted in the immediate postoperative period irrespective of contents.
Yeow
Kee-Min
KM
Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Chang Gung University, Tao Yuan, Taiwan, R.O.C. kmyeow@adm.cgmh.org.tw
Liao
Chun-Ta
CT
Tsay
Pei-Kwei
PK
Chen
I-How
IH
Cheng
Ming-Hui
MH
Chen
Hung-Chi
HC
Wei
Fu-Chan
FC
D004322:Drainage / Q000379:methods; D005122:Exudates and Transudates; D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006406:Hematoma / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D011183:Postoperative Complications / Q000628:therapy*; D012463:Saliva; D013492:Suppuration; D018084:Ultrasonography, Interventional