International Journal of Otolaryngology / 2017 / Article / Tab 2

Review Article

Management of Chyle Leak after Head and Neck Surgery: Review of Current Treatment Strategies

Table 2

Literature review of somatostatin and octreotide for treatment of chyle leak.

AuthorYearPatientsSurgeryTreatment dosageTreatment durationTreatment start to leak cessationAdditional measuresComments

Somatostatin

Coşkun and Yildirim [19]20101Thyroidectomy + L MRND3 mg iv Qday5 days1 daySuction drainage
Dietary modifications

Ulíbarb et al. [20]19901Supraglottic laryngectomy + L MRND6 mg iv Qday12 days5 daysSuction drainage
Dietary modifications
Pressure dressing

Octreotide

Ahn et al. [21]20122L MRND (1)
Thyroidectomy + R MRND (1)
100 µg sc Q8–1211 days11 daysSuction drainage
Pressure dressing

Al-Sebeih et al. [22]20011Total laryngectomy + B MRND100 µg sc Q8Not specified3 daysSuction drainage
Dietary modifications
B chylothoraces requiring chest tubes

Harlak et al. [23]20081R MRND100 µg sc Q815 days15 daysSuction drainage
Dietary modifications
Pressure dressing
Surgical exploration w/fibrin glue
Metastatic breast cancer
Reexploration for persistent leak

Jain et al. [24]201519Left neck dissection (19)100 µg sc Q8Low output 5 days
High output 7 days
Low output 2–4 days
High output 5 days
Suction drainage
Dietary modifications
Pressure dressing
Low output <500 mL/24 hours,
high output >500 mL/24 hours

Jiménez et al. [25]20081Thyroidectomy + B MRND100 µg sc Q8 > somatostatin 6 mg iv Qday11 daysN/ASuction drainage
Dietary modifications
Surgical Exploration
Right sided chyle leak
Leak resolved with definitive surgical intervention
Switched from octreotide to somatostatin

El Dabe Mikhail et al. [26]20091ThyroidectomyNot specified5 days5 daysDietary modifications
Pressure dressing

Nyquist et al. [27]20031Thyroidectomy + L MRND100 µg sc Q88 days1 daySuction drainage
Dietary modifications
Pressure dressing

Ogi et al. [28]20131Thyroidectomy + B MRND100 µg sc Q123 days3 daysSuction drainage
Dietary modifications

Prabhu and Thomas [29]20151L radical neck dissection100 µg sc Q814 days14 daysSuction drainage
Dietary modifications
Surgical exploration w/tetracycline
L chylothorax
Side effect: vomiting

Rodier et al. [30]20111Thyroidectomy + central & L MRND (1)100 µg sc Q86 days6 daysSuction drainage
Dietary modifications

Srikumar et al. [31]20061L radical neck dissection200 µg sc Qday14 days14 daysSuction drainage
Dietary modifications
B chylothoraces requiring chest tubes

Suver et al. [32]20041B MRND + mediastinal dissection4 µg/kg/hr77Suction drainage
Dietary modifications
Lymphatic malformation in 10-month-old child

Suslu et al. [33]20143Thyroidectomy + L MRND (1) Thyroidectomy + B MRND (1)
Radical neck dissection (1)
100 µg sc Q87.56.5Suction drainage
Dietary modifications
Surgical exploration
L chylothorax (1)
Failed surgical exploration (2)
Laterality not specified

Swanson et al. [34]201512L MRND (3)
R MRND (1)
Thyroidectomy + B MRND (3) Thyroidectomy (4)
Parathyroidectomy (1)
100 µg sc Q89.45.5Suction drainage
Dietary modifications

Touska et al. [35]20021R completion thyroid lobectomy200 µg sc Q81710Suction drainage
Dietary modifications
No suction drain initially
Reoperation for suspected abscess
Discharged with 7-day course of octreotide

Valentine et al. [36]20021Thyroidectomy + L MRND50–100 µg sc Q82424Suction drainage
Dietary modifications
Octreotide dose increased from 50 ug to 100 µg sc Q8 not effective

Khurana et al. [37]20091Thyroidectomy + B MRND100 µg sc Q8Not specifiedNot specifiedSuction drainage
Dietary modifications
Surgical exploration
B chylothoraces requiring chest tubes
Leak site not identified

L = left; R = right; B = bilateral; MRND = modified radical neck dissection.