Definition and Overview

Patients who have undergone neck surgery are typically scheduled for a follow-up consultation following the procedure to gauge the success of the operation and monitor the development of any complications so they can be addressed immediately.

There are different reasons why neck surgery is performed. One of its main uses is to treat problems affecting the cervical spine, or the uppermost region of the spine that is within the neck area.

Spine surgeons, however, express that neck surgery should be carried out only when the source of pain has already been identified. This means the surgery is not for exploratory purposes. Further, it is an elective treatment option and is only performed when all non-surgical options such as yoga and chiropractic, among others, didn’t work.

Neck surgery is typically recommended to correct a physical deformity, manage chronic pain, or decompress a pinched nerve.

The surgery is also ideal for patients who have issues affecting the larynx, throat, or the neck itself. For example, a tumor or mass may be growing around the area. A surgery may be needed to excise the tumor and perform a biopsy to determine whether the tissue sample is malignant or benign.

Regardless of the reason and the advancements in the field, which include minimally invasive methods, the procedure still has risks and complications that require post-operative care.

Who Should Undergo and Expected Results

A neck surgery follow-up is a requirement for all patients who have undergone the procedure, whether it’s invasive or minimally invasive. Surgeons work hard to ensure that the risks and complications are controlled or prevented. However, in certain cases, these problems develop a few days or months after the surgery. The follow-up care is, therefore, essential to detect these problems the earliest time possible so they can be addressed promptly and to avoid complex complications from developing.

It may also be performed to detect recurrence. Neck cancer, for example, has a very high cure rate especially when it’s detected early. But it can also recur. In fact, at least 30% of localised neck cancer can happen again while 20% may become metastatic, which means the cancer has spread to nearby organs before it is detected.

A follow-up care can also be helpful in improving counsel for patients who may need a change in lifestyle to maintain the quality of life after surgery. For example, patients may be required to stop smoking especially after surgery or when diagnosed with neck cancer.

How Does the Procedure Work?

The surgeon discusses the follow-up care prior to the procedure as he is expected to cover everything about the surgery early on.

The actual follow-up usually begins as soon as the patient has been discharged from the hospital. The schedule is discussed before the patient leaves. As to when the follow-up appointments happen, it depends on the purpose.

The first follow-up for patients who have undergone neck surgery is scheduled around the first week following the operation. The surgeon’s main mission during this time is to check for any complications on the surgical site. For example, if the patient has his voice box or larynx removed, which resulted to a stoma, the surgeon will check for infection and change the dressing. The patient will also be advised on the activities he may have to avoid over a certain period as well as how to maintain the cleanliness of the surgical site.

As the site heals, the follow-up care may be adjusted to once a month or once every three months. This will be the case for the next few years, especially if the objective is to prevent, minimize, or manage recurrence promptly.

During the follow-up, the surgeon may request for certain tests to gauge if there’s any problem with the surgery or the healing process. He will also work closely with other physicians treating the patient like an oncologist, who specializes in cancer, to ensure that the patient is able to cope with the surgery and the illness well.

Possible Risks and Complications

It’s possible that the patient may take the follow-up care for granted. This means he doesn’t keep up with the appointments, or he ignores them completely. Patients who do this may have the wrong idea that they are already completely healed after surgery, and they don’t need monitoring, or they think they already know what to do. Another reason would be distance and immobility.

Physicians responsible for follow-up care need to set up a system that encourages close monitoring and notifications of patients. They can use tools like smartphone apps or video conferencing to carry out follow-ups, although it’s essential they meet with the patient a couple of times during the follow-up period as physical examination and other tests may need to be carried out.

Reference:

  • 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.
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