Background
Major Head and Neck surgeries are complex operations. However, few data exist on complication rates of Head and Neck surgeries globally. Understanding the rate and type of complications from these procedures are important to identify areas of procedural and peri-operative improvement, and guide patients on the likely outcome of their procedure.
Methods
A retrospective analysis of the Head and Neck database from Hutt Valley District Hospital was carried out. Data from between 1995 and 2021 was analysed to look at the total complication rate and the severity of complications as per the Clavien-Dindo classification of major Head and Neck surgeries. Major Head and Neck surgeries included regional flaps, free flaps, parotidectomy and neck dissection for cutaneous or oral squamous cell carcinoma (SCC).
Results
A total of 377 oral SCC patients and 392 cutaneous SCC patients met the criteria. For oral SCCs, 164 patients (44%) had 180 complications. As per the Clavien-Dindo classification, 17 (9.4%) oral SSC complications were Grade 1, 53 (29%) were Grade 2, 105 (58%) were Grade 3, 2 (1%) were Grade 4, and 3 (1.7%) were Grade 5. For cutaneous SCCs, 134 patients (34%) had 155 complications. As per the Clavien-Dindo classification, 23 (15%) cutaneous SCC complications were Grade 1, 44 (28%) were Grade 2, 85 (55%) were Grade 3, 2 (1.3%) were Grade 4, and 1 (0.6%) were Grade 5.
Discussion
The majority of complications were Clavien-Dindo Grade 3 which require surgical, endoscopic or radiological intervention. There are many factors that may determine the complication rate seen with major Head and Neck surgeries but given the high rate of Grade 3 complications modifiable preventative measures need to be identified.
Conclusion
Grade 3 complications are significant complications, highlighting a need to assess possible preventative measures.