Head and Neck Surgery

Surgery on the head and neck is done to treat many different diseases, disorders, and injuries. Head and neck surgeries are most often performed by an otolaryngologist [AH-tow-LAHR-in-JAW-low-JIST]. This is a doctor who specializes in the ears, nose, and throat (ENT), as well as other structures of the head and neck. However, surgeries on the brain are done by a neurosurgeon [NOO-roh-suhr-jun] and surgeries on the spine are done by an orthopedic [or-thoh-PEE-dik] surgeon.

A few of the conditions that may require head and neck surgery include:

• Injury. Severe head and neck injuries may need surgery to repair damage or save your child’s life.
• Tonsillectomy [tohn-sil-ECK-tuh-mee]. This surgery removes your child’s tonsils [TOHN-sils]. It was once common for children to have their tonsils removed, but it is much less common today.
• Cleft lip/cleft palate. This birth defect can affect your child’s lip, soft palate, or both. A cleft lip/cleft palate did not fully fuse during fetal development, and it requires surgery to connect the two sides of the lip, the palate, or both.
• Cancer. While cancer is rare in children, it does happen. Pediatric thyroid [THEYE-roid] cancer affects the thyroid gland, which releases hormones that regulate your child’s growth. It’s one of the most common types of cancer in children. Some otolaryngologists specialize in treating it. Like other cancers, thyroid cancer often requires surgery to remove tumors before other treatments, like radiation and chemotherapy [kee-moh-THER-ah-pee], can start.
• Cochlear implants. A cochlear implant is a small, complex electronic device that can help to provide a sense of sound. This surgery is done to help people who cannot hear anything or are severely hard-of-hearing. An implant does not restore normal hearing, but it can help a person understand speech.

The type of surgery your child has will depend on why they are having it.

There are some risks common to all types of surgery, including head and neck surgery. These include:

• Infection at the surgical site.
• Damage to surrounding tissues.
• Bleeding at the site or from nearby blood vessels.

The benefits of head and neck surgery depend on the nature of your child’s health concern. In some cases, such as when the surgeon repairs a damaged windpipe, the benefits can be life-saving. In other cases, such as when the surgeon installs cochlear implants, the benefits can be a major improvement in your child’s quality of life. For tonsillectomy, the benefit may be fewer sick days for your child.

Children of all ages have questions and fears. These fears are often worse than what happens during surgery. You can help your child by knowing what to expect when they have surgery. Some questions you can ask your child’s doctor include:

• Will my child need antibiotics before or after surgery?
• When does my child need to stop eating or drinking?
• What exactly will the surgeon do?
• How long will it take?
• When can I see my child after the surgery is done?
• Will my child have side effects from the anesthesia?
• How long will they need to stay in the hospital?
• What activities should my child avoid after the surgery?
• How long will it take to heal?

You will meet with an otolaryngologist who will examine your child and confirm whether surgery is necessary. They will explain the procedure and answer questions from you and your child.

On the day of the surgery, a nurse will prepare your child for the procedure. The surgeon may use a marker to draw on your child. The marks will help them know where to operate.

An anesthesiologist [ann-ess-TEE-see-AH-loh-JIST] will give your child medicine to make them sleep (anesthesia). Younger children may breathe the medicine through a mask, but sometimes it’s safer to put the medicine directly into your child’s vein with an IV. An IV is a tiny, flexible tube. Your child will go to sleep quickly, and then the operation will start.

The surgery itself will vary depending on your child’s health concern. Ask your surgeon to explain the procedure so that you understand what they will be doing.

Sometimes, you will know right away if your child’s surgery worked. Other times it might take longer to know if the surgery was a success. This depends on the type of surgery your child had, and whether your child had other health concerns. For example, if the surgeon removed a cancer tumor, they probably also took a tissue sample for testing (biopsy [BY-op-see]). It may take several days or more to get those results. If the surgeon put in cochlear implants, your child will go through an extensive process to get them working and to learn how to use them.

Your child’s surgeon will want to see your child again after the surgery to see:

• How the area is healing
• How the area looks after the swelling goes downIf there is a problem with the surgery

Most follow-up care can be provided by your child’s primary care provider. They will want to follow your child to ensure they continue to grow and function the way they should.

Your child may need head and neck surgery for many reasons. In most cases, an otolaryngologist will perform the surgery. An otolaryngologist is a doctor who specializes in conditions of the ears, nose, and throat, as well as other structures in the head and neck.,. Some head and neck surgeries are minor and don’t need anesthesia or a hospital stay. Others can be complex, and for those your child may need to be given anesthesia for surgery and stay in the hospital for a short time to recover.