International Journal of Head and Neck Science

Articles Abstract

International Journal of Head and Neck Science

June 2019
Volume 3, Number 2

Edited by: Chih-Yen Chien, MD
ISSN: eISSN 2520-5900, pISSN 2663-8835

Review Articles

Complications and “Near-Miss” in Head and Neck Oncologic Surgery

Patrick J Bradley1

1 Department of Otorhinolaryngology, Head and Neck Surgery, Nottingham University Hospitals, Queens Medical Centre Campus, Nottingham, England


head and neck surgery; complications; neoplasms


The quality of surgery in head and neck oncology can be evaluated by analysing a number of measurable indicators as a proxy for surgical performance which may alter or delay patients’ transit through their period of hospitalisation. A surgical complication and its consequences is a major factor that delays a timely discharge. The Clavien-Dindo classification of Surgical Complications subdivides the severity of surgical complications into five grades according to the additional medical resources required
to treat the patient.

The published literature on surgical complications was reviewed, using PubMed search, and consulting textbooks on “Complications in Head and Neck Surgery” as to the causes, effects, and ability to identify high-risk patients and to implement strategies that may minimise complications.

It has been estimated that > 50% of complications judged to be preventable, and interventions directed at human causes are to be recommended. Three complications haemorrhage (preoperative and postoperative), wound infection and pharyngo-cutaneous fistula are recognised as the most common complications in primary and salvage surgery.

Routine data collecting with detailed analysis, identification of patters of occurrence, and eradication would be a major start to reducing life-risk major surgical complications. The Clavien-Dindo classification requires several modifications, specifically for head and neck surgery to identify several unique areas allowing for greater documentation of the results of surgery to be registered and analysable.