11. Surgical complications and adverse effects

Most patients with oral cancer undergo some form of surgical intervention, ranging from the diagnostic to the therapeutic, and from major to minor. Because of the anatomic location of the vital organs of speech, swallowing, and respiration, complications can arise from surgery which may be severe, debilitating or even fatal. Bilateral neck dissection in particular can result in increased morbidity and mortality with higher rates of infection, fistulae and complications such as facial oedema, particularly if both internal jugular veins are simultaneously sacrificed.

It is crucial that all such potential complications are discussed with the patient prior to surgery, and balanced against other options for treatment. The dental team should also be aware of the various possibilities.

For at least the 24 h or so after surgery post-operative pain is usually present; at first constant, but eventually present only on local pressure. For the first 48 hours pain should be controlled with regular analgesia (see Article13). Severe pain may need to be controlled by opioids.