Post operative care following head and neck surgery

How you will feel

You will be drowsy and tired following surgery due to the medicines we have given you to make you comfortable. Most people wake and doze on and off during the evening after surgery. The day following surgery, you may still feel a bit tired, but you will soon regain your energy. You may move about normally without fear of disrupting your surgery. Your energy will return more rapidly if you do.

If you have nausea

Although we give anti-nausea medicines before, during and after your surgery, it’s still not unusual to have some nausea following surgery. Relax, decrease your activity and don’t eat any heavy foods—just try some clear liquids. All nausea should be over 8-10 hours following surgery.

Discomfort

You may have some discomfort around your incision and neck. Usually this is due to muscle soreness. We’ve given you a pain medicine to be used as directed. Take a pain pill before going to sleep the evening of surgery (preferably after you have kept something in your stomach). Take another pain pill the morning following surgery since you may feel a bit stiff and uncomfortable when you begin to move about. After two days, extra strength Tylenol may control your discomfort instead of the narcotic.

Swelling

You may expect some swelling and discoloration around your neck if you had a neck incision. This swelling will increase overnight. To reduce swelling, you may gently apply an ice pack to the surgical incision during the first 48 hours following surgery. If possible, sleep with your head elevated on two pillows. Most of your swelling should subside over 4 to 5 days.

Fever

Fever of less than 38.5C (101F) following surgery is common. Please call if your fever reaches 38.5C(102F).

Antibiotics and Infections

You may have received antibiotics in your IV prior to surgery, but may need to continue taking antibiotics as prescribed after surgery. Infection after surgery is rare, but if you notice increased redness or swelling accompanied by tenderness or fever at any time, please call us so that we may examine you.

Activity

You may resume light activity as you start to recover from surgery. You should avoid any heavy lifting or straining for at least a week after surgery. Strenuous sports should be avoided for at least 2 weeks. This is to prevent increase in swelling or bleeding in the surgical area.
You may return to work when you feel ready. Generally, people return to work within a week.

Diet

There is no diet restriction after surgery. If your throat is sore, a soft diet may be preferable. With a Zenker's resection, you may prefer soft or pureed food for a few weeks.

Dressings

You will have your incision closed with stitches. You may or may not have a dressing where your incision was made. Usually, this will consist of small strips of tape. The stitches are underneath these. If the strips of tape fall off, it is OK. You can simply cut whatever piece is starting to fall off and leave the rest alone, but do not cut the stitches. If you have stitches, they will be removed about 1 week after surgery.

Drains

If you were sent home with a drain, you will be instructed on caring for it by the nurses at the hospital. You should record the daily output and inform your physician how much has come out when you return to the office to have it removed. It will usually be removed within a couple days after surgery.

Personal Hygiene

For the first 3 days, keep your incision dry (you can sponge bathe). You may shower as usual after 3 days. Please clean around the incision and keep the surgical site clean. You may use soap and water. Take care to treat your incision gently. Keep your dressings clean and dry.

Numbness

You will have some numbness around your incisions, cheek and ear. The sensation will return within a few weeks to months. Following a parotidectomy the lower half of the ear lobe will stay permanently numb (this does not affect hearing). This does not usually pose a problem but can be aggravating.

Facial Weakness

We use very gentle technique during your surgery, and watch for nerves to protect them. However, it is possible to have some temporary nerve weakness in your face after the surgery. Generally this occurs around the corner of the mouth. It is usually very mild and returns within a few weeks. If the eyelid is weak, your eye may not be adequately protected, and will become irritated. Contact Dr. Mostachfi to receive instructions on proper eye care. It is rare to have any permanent facial weakness.

Other problems

Other problems to look for include Frey’s Syndrome, following parotid surgery. This is where you sweat along your cheek when you get hungry or eat. Hematoma or seroma is a collection of blood or fluid under the skin. This requires immediate attention and drainage to avoid further complications with healing. Keloid formation can occur in persons prone to these problems, such as dark skinned individuals. Asymmetric ear lobes can occur depending on how your incision heals. Hoarseness can occur following a Zenker's resection.

Follow-up

Call the office to check your follow-up time. We will want to see you one week post op, to remove drains and monitor your progress.