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Complete Neck Dissection
Wound Infection | Bleeding | Skin Breakdown and Scar | Nerve Injury | Anesthesia | Pre-Oper-ative Instructions |Post-Operative Instructions | Wound care | Medications | Activity | Nutrition
Complete neck dissection is performed in order to remove known or suspected lymph nodes containing cancer that have spread from the primary tumor site. Its purpose is to prevent further spread of that disease to other parts of the body. Over the past 100 years neck dissection has proven to be an effective method of head and neck cancer control.
Quality of life after complete neck dissection is only minimally affected. The major permanent undesired effects are some shoulder weakness, pain in the neck and surgical scar, but these are a small price to pay for a cancer cure.
Wound infection
Infection can lead to a non-healing wound, skin breakdown, bleeding and leakage of lymph fluid. You will be given antibiotics through your IV to prevent infection.
Bleeding
The need for a transfusion is rare, but nevertheless could be a potential complication.
Skin Breakdown and Scar
Skin breakdown is most commonly a result of infection or previous radiation effect, and can be managed with antibiotics. The surgical incision will be placed in a natural skin fold, thus minimizing any ring. Keloid or thick scarring is uncommon in surgery of the head and neck.
Nerve Injury
Injury to nerves controlling the lower face, throat, shoulder, tongue, diaphragm and skin sensation under the ear and jaw is a potential risk of this procedure. Depending on the involvement and proximity of the tumor to the facial and neck nerves, you may experience temporary nerve damage, permanent nerve damage or both. If nerve damage is temporary (most commonly due to swelling), full function may take six to eight months to return. Permanent damage (when the tumor has invaded the nerve, therefore making it necessary to remove part of the nerve) usually is in combination with temporary damage. Therefore, some improvement from the immediate postoperative period may be anticipated. Every care will be taken, as well as monitoring throughout your procedure, to minimize nerve damage. If loss of nerve function to the muscles of the neck and shoulder are involved, you will be given exercises to strengthen areas of weakness.
Anesthesia
Complications from anesthesia are known to exist. These, along with other complications, are mostly related to the risks of any major surgery in older or debilitated patients. For that reason, a medical consultant may be asked to assist the surgeon in postoperative management. Please notify the office at 256-3550 for any concerns. We are all here to help in any way we can.
Pre-Operative Instructions
- Do not have anything to eat or drink after midnight prior to your surgery. This includes all food, all liquids, water, candy, mints and gum. Your surgery may be cancelled if you do not follow these instructions.
- Please do not take aspirin or aspirin containing products, ibuprofen or ibuprofen containing products or Vitamin E for one week prior to your surgery. If you take any medications that affect your bleeding time (Coumadin or Warfarin, arthritis medications, muscle relaxants to name a few) please let Dr. Coniglio's office know at this time.
- Please inform Dr. Coniglio's office at this time if you take routine medications.
- Prior to your arrival at the hospital, please be certain all make up, nail polish or false nails are removed. This assists in monitoring your blood oxygen level.
- Please leave all valuables (money, credit cards, jewelry, watches) at home.
- During your surgery your family may wait in the Main Lobby on the first floor of the hospital. The nurses will provide directions. Dr. Coniglio will contact your family there by telephone following your procedure.
- You will be admitted to one of the surgical units in the hospital. Your family may bring your belongings in at that time. It is recommended that you do not keep valuables with you while you are in the hospital.
- A map to the hospital is available for your convenience. Please ask if you have any questions about finding your way to the hospital.
Post-Operative Instructions
Your hospital stay will be approximately two to seven days, depending on the extent of the surgery required to examine the nodes of the neck and/or remove the tumor. Pathology results may take anywhere up to two weeks but usually are available after one week to ten days. If you have not received the results after ten business days, please call our office.
Wound care
The surgical incision will be placed in a skin fold to minimize scarring. Steristrips over the surgical wound are to remain dry and in place for approximately two weeks postoperatively. A drain will be placed to collect excess tissue fluid from the site of the surgical incision. This drain will remain in place until the drainage is minimal. The drain will be removed prior to hospital discharge and a small dressing placed over the drain site. Your follow-up appointment for suture removal should be approximately 7 - 14 days after surgery.
Medications
You will resume all daily medications as prescribed. A prescription for antibiotics will be provided at the time of hospital discharge if this is indicated. A prescription for pain medication will also be provided as well as a swelling medication if indicated.
Activity
Neck swelling and numbness are to be expected after neck dissection, and may persist up to three months following surgery. You will be asked to avoid heavy lifting, bending or straining following surgery for at least two weeks. Dr. Coniglio may recommend neck exercises and, if indicated, physical therapy for neck and arm muscles.
Nutrition
Your nutritional needs are fundamental in proper wound healing. The goal is to avoid dehydration and maintain adequate nutrition. Following surgery your diet will gradually be advanced from clear liquids to solid food.
Notify the office for any of the following:
- difficulty breathing or painful swallowing
- coughing up blood or persistent bleeding (You may notice some slight blood tinged sputum, which is not uncommon.)
- significant swelling of the neck or back of throat
For an emergency please call our professional answering service at 585-258-4840.
Please notify the office 585-256-3550 for any concerns. We are here to help in any way we can.
Dr. John U. Coniglio and Staff
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