10/21/2023 0 Comments Serosanguinous fluid after surgery![]() ![]() 18 As head and neck surgical techniques have evolved, so have the type and frequency of complications. 14 – 17 In addition, SND may be the preferred approach for planned neck dissection after concurrent chemoradiation for advanced head and neck cancer because these patients have a low incidence of recurrence in the neck. 12, 13 This approach is highly effective for management of the clinically negative neck and may have applications in clinically positive necks as long as postoperative radiation therapy is administered. 8 – 11 Further technique refinements that established selective neck dissections (SND) were based on predictable patterns of spread from specific primary tumor locations. 7 Introduction of the modified radical neck dissection (MRND) and proof that it was oncologically sound led to improved functional outcomes without sacrifice of oncologic effectiveness. 6 In that era, radical neck dissection (RND), with removal of the sternocleidomastoid muscle (SCM), the internal jugular vein (IJV), and the spinal accessory nerve (SAN), was considered the standard of care for patients with neck metastasis but resulted in significant functional and cosmetic morbidities. 5 The results of a systematic approach to cervical lymphadenectomy for the treatment of a series of patients with head and neck cancer was first reported by George Crile, MD, in 1906. The history of neck dissection reveals a continuing quest to reduce complications and their sequelae. 1 – 4 Prevention and management of complications that occur both intraoperatively and postoperatively are essential to proper head and neck surgical care. Factors such as medical comorbidities (hypertension, hepatitis, etc.), substance abuse, prior radiation therapy, aerodigestive tract entry, prolonged anesthesia times, the volume of intraoperative fluid administered, and the need for microvascular free flap reconstruction have been associated with head and neck surgical complications in various studies. Despite our best intentions, complications arise due to the intricate anatomy of the neck and complexities of the diseases and patients treated. Awareness, early recognition, and prompt and effective management of complications can have a significant impact on outcomes.Ĭomplications of neck surgery affect every surgeon regardless of experience and technical skill.
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