Head and Neck Malignancies and Neck Dissection Complications: A Cohort Study from a Tertiary Care Centre in Telangana, India

Abstract

Introduction: Complications after major surgery are a significant cause of morbidity and mortality, and they have been shown to harm long-term quality of life. Lymph node status is the chief prognostic indicator. In the head and neck, complications from oncosurgeries can also delay adjuvant treatment, which is known to adversely affect survival. Neck dissection is a standard procedure for head and neck cancer following resections of the primary tumour. The invasive nature of neck dissection predisposes patients to a variety of intraoperative and postoperative complications. Aim: To analyse the complications in patients with head and neck malignancies following neck dissections. Materials and Methods: This was a single-centre cohort study conducted at the Department of Surgical Oncology, Nizam’s Institute of Medical Sciences, Hyderabad, Telangana, India. All patients diagnosed with head and neck malignancies who underwent neck dissections from July 2022 to December 2022 were included in the study. Complications such as bleeding, haematoma, infection, seroma, wound dehiscence, flap necrosis, fistula, chyle leak, shoulder dysfunction, and nerve and vascular injuries following various neck dissections were observed until discharge. The data was entered in Microsoft excel and results were expressed in terms of frequency and percentage. Results: A total of 67 patients were analysed in this study. Among them, 42 (62.7%) were males and 25 (37.3%) were females, with a mean age of 48 years and an age range of 25-84 years. Three patients underwent bilateral neck dissection, and a total of 70 neck sides were studied. Among the patients who received prior radiotherapy (20, 29.8%), 6 (30.0%) experienced complications, and there were no deaths. Conclusion: Head and neck surgery carries the potential for many complications due to the presence of major vessels and nerves. Carefully performed surgery is the cornerstone of success. Thorough preoperative assessment, proper surgical technique, and postoperative care are essential in preventing and managing complications. A step-by-step approach to studying details and conducting a complete check-up of the patient after the procedure ensures optimal results with minimal late side-effects and complications.

Keywords

• chyle leak
• haematoma
• nerve injury
• seroma