Definition and Overview
Patients who are about to undergo any type of neck surgery have to meet with their surgeon. This consultation is intended to determine whether the patient is eligible for it, to provide a second opinion, or prepare the patient for the surgery. It is not meant to diagnose a condition affecting the neck.
There are many different types of neck surgery and they can be either open or invasive, or minimally invasive. Some of the most common open surgeries include laryngectomy, or the removal of the larynx, and laminoplasty, or lamina reshaping to give more room for the roots of the nerves (this is in relation to spinal problems).
Some types of neck surgery can be performed using minimally invasive techniques wherein only small incisions are involved. Often, a scope, equipped with a light and a camera, is utilized to guide the surgeon, and fine surgical instruments are then used to perform the procedure. In certain instances, devices such as laser are also utilized. The main advantages of this type of surgery are faster recovery, fewer risks or complications, and less harm to the nearby organs and tissues.
Who Should Undergo and Expected Results
A neck surgery consultation may be recommended for patients who have neck problems and are not responding to non-surgical treatments.
For patients with problematic spine that affects the neck area or the cervical region, a surgery is often elective, which means it is not a requirement. The main line of treatment for such conditions includes manual correction or manipulation, medication, massage, therapy and yoga, among others. Moreover, it is not recommended unless the actual source of the problem or the pain has already been determined or identified. Surgery therefore is not used to locate the cause of the pain.
On the other hand, there are situations when neck surgery is the first and only option, such as in cases where patients are diagnosed with neck or throat cancer. Surgery is needed to remove the mass and hopefully prevent the spread of the disease to other organs. Neck surgery is also primarily considered during traumatic injuries like a burn or a serious neck or spinal fracture.
A consultation is also recommended for those who wish to undergo neck lift surgery, a kind of cosmetic procedure that involves skin tightening. This is to ensure that the individual knows the benefits as well as possible risks and complications of the surgery. Also, a consultation helps the surgeon determine whether the individual is eligible for the procedure.
If a patient is doubtful of the initial surgical suggestion, he may approach another surgeon for a second opinion.
How Does the Procedure Work?
Patients who require neck surgery are typically referred by their primary physician, which can be an oncologist (for cancer patients), chiropractor or other spine specialists (for patients with spine issues) and otolaryngologist (a doctor who specialises in conditions affecting the nose, ear and throat) to the neck surgeon.
Because the patient has been referred, it’s expected that diagnostic tests have already been performed and that the patient has a medical record. These records are usually forwarded to the surgeon’s office a day or two before the first consultation.
During the consultation, the surgeon:
- Reviews the medical records
- Interviews the patient about his medical and family history (e.g., if there are other family members with arthritis or a known neck condition)
- Asks about other treatments performed or medications taken and their effects on the patient
The patient, meanwhile, must share his current physical condition and thoughts about the diagnosis as well as his thoughts about it and the surgery.
Depending on the analysis of the surgeon, he may recommend more tests before he can decide whether the patient needs the surgery and if so, the kind of procedure that is most appropriate based on the patient’s condition and unique circumstances.
The first consultation is normally the longest, lasting for at least an hour. As the patient nears the surgery, the appointments will be more frequent but usually shorter (around 30 minutes).
Possible Risks and Complications
It’s possible that the patient will not proceed with the surgery. Although the patient always has the final decision, electing to go against it may be only more harmful to his health, worsening the condition or putting his life in danger.
There are many reasons why a patient decides against surgery, but most of them are factors that can be managed by the surgeon. For one, patients need to have a clear idea about the surgery, such as the benefits, risks, costs and methods to be used. It’s equally important for them that they know the surgeon is capable and helpful. Otherwise, if they feel the surgeon is ineffective during the pre-operative phase, they may be less likely to cooperate.
- Pfaff JA, Moore GP. Otolaryngology. In: Marx JA, Hockberger RS, Walls RM, eds. Rosen's Emergency Medicine. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 72.