Abstract
Lymphatic leakage is an uncommon but significant complication following head and neck surgeries, potentially leading to malnutrition, electrolyte imbalances and prolonged hospitalization. We report a case of a 69-year-old male with hypopharyngeal carcinoma who developed right neck lymphatic leakage 2 weeks post total laryngectomy and bilateral radical neck dissection. Despite conservative management, including low fat diet, the leakage persisted. Lymphangiography via right axillary lymph node access using a 25-gauge spinal needle revealed lipiodol pooling at the right supraclavicular fossa, confirming the leakage site. Subsequent embolization with 2 mL of 33% N-butyl cyanoacrylate (NBCA) glue successfully resolved the leakage. This case highlights a novel approach in managing neck lymphatic leakage through axillary lymph node access, offering an effective alternative for patients who are unresponsive to conservative treatment and lack accessible cervical lymph nodes.