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흉쇄유돌근의 회전피판을 이용한 수술 중 발생한 유미루의 치료 1예

Case Report: Intraoperative Management Using Inferior Based Rotation Flap of Sternocleidomastoid Muscle for Chyle Fistula

  • 김서빈 (고신대학교 의과대학 이비인후-두경부외과학교실) ;
  • 이형신 (고신대학교 의과대학 이비인후-두경부외과학교실) ;
  • 이강대 (고신대학교 의과대학 이비인후-두경부외과학교실) ;
  • 김성원 (고신대학교 의과대학 이비인후-두경부외과학교실)
  • Kim, Seo Bin (Department of Otolaryngology - Head and Neck Surgery, Kosin University College of Medicine) ;
  • Lee, Hyoung Shin (Department of Otolaryngology - Head and Neck Surgery, Kosin University College of Medicine) ;
  • Lee, Kang Dae (Department of Otolaryngology - Head and Neck Surgery, Kosin University College of Medicine) ;
  • Kim, Sung Won (Department of Otolaryngology - Head and Neck Surgery, Kosin University College of Medicine)
  • 투고 : 2016.10.17
  • 심사 : 2016.11.07
  • 발행 : 2016.11.30

초록

Chyle fistula is one of the complications of neck dissections. Although immediate surgical repair seems to be the best choice when chyle leakage is observed during the operation, some operators can be embarrassed when chyle leakage is heavy and not controlled during surgery. In this case, chyle leakage was occurred after extensive resection of lymph nodes in left level IV, and was not controlled in any way. The clavicular head of sternocleidomastoid muscle was dissected and inferior-based muscular flap was rotated to cover the suspected region of fistula orifice. Amount of drainage was checked less than 20 ml per day in the following days, and drain tube was taken out on the 3rd postoperative days. We present the technique using the inferior based sternocleidomastoid muscle flap for intraoperative management of chyle leakage not easily controlled.

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