title: Therapeutic role of ultrasound-guided intranodal lymphangiography in refractory cervical chylous leakage after neck dissection: Report of a case and review of the literature.
abstract: BACKGROUND
  Chylous leakage is a well-recognized but rare complication of head and neck surgery, affecting approximately 1% to 2.5% of head and neck dissections. It is a potentially life-threatening condition characterized by electrolyte imbalance, immunosuppression, delayed wound healing, risk of infection, and generalized sepsis. Management can be problematic and prolonged.
  
  
  METHODS
  We present a case of refractory cervical chylous leakage after neck dissection treated with ultrasound-guided intranodal lymphangiography.
  
  
  RESULTS
  Ultrasound-guided intranodal lymphangiography alone resulted in rapid and complete resolution of chylous leakage with minimal morbidity.
  
  
  CONCLUSIONS
  Based on our clinical experience and after a thorough literature review, we propose that ultrasound-guided intranodal lymphangiography with contrast agent could be considered a viable therapeutic option for persistent chylous leakages in selected patients.
authors.affiliation: Department of Oromaxillofacial Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.|Department of Stomatology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
authors.forename: Chia-Yu
authors.initials: CY
authors.lastname: Chen
authors.affiliation: Department of Oromaxillofacial Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.|Department of Stomatology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
authors.forename: Yu-Hung
authors.initials: YH
authors.lastname: Chen
authors.affiliation: Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
authors.forename: En-Li
authors.initials: EL
authors.lastname: Shiau
authors.affiliation: Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
authors.forename: Hui-Lung
authors.initials: HL
authors.lastname: Liang
authors.affiliation: Department of Stomatology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.|Dental Laboratory Technology, Shu Zen College of Medicine and Management, Kaohsiung, Taiwan.
authors.forename: Hao-Sheng
authors.initials: HS
authors.lastname: Chang
authors.affiliation: Department of Oromaxillofacial Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.|Dental Laboratory Technology, Shu Zen College of Medicine and Management, Kaohsiung, Taiwan.
authors.forename: Hung-Chih
authors.initials: HC
authors.lastname: Chen
mesh_terms: D002913:Chyle / Q000000981:diagnostic imaging*; D003287:Contrast Media; D004621:Embolization, Therapeutic; D004998:Ethiodized Oil; D006801:Humans; D008220:Lymphography; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000009:adverse effects*; D013897:Thoracic Duct / Q000000981:diagnostic imaging*; D018084:Ultrasonography, Interventional
chemical_list: D003287:Contrast Media; D004998:Ethiodized Oil
keywords: chylous leakage; intranodal lymphangiography; radical neck dissection; total parenteral nutrition; ultrasound-guided