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Laryngeal, Pharyngeal and Head & Neck Procedures

This document provides patient-friendly information on common laryngeal, pharyngeal, and head & neck procedures. It includes preoperative preparation, the basic steps of the operation, and postoperative care. The details are simplified for general awareness and should not replace a consultation with your doctor.

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Laryngeal Procedures

Microlaryngoscopy

Preoperative Preparation

  • Fasting for 6–8 hours, routine blood tests, voice evaluation.

Operation Details

  •  A microscope and laryngoscope are used to visualize the vocal cords. Polyps, nodules, or lesions may be removed.

Post operative Care

  • Voice rest for a few days, avoid shouting or whispering, regular follow-up.

Tracheostomy

Preoperative Preparation

  • Consent, neck examination, imaging if needed.

Operation Details

  •  A small incision is made in the neck and trachea; a tube is inserted to help breathing.

Post operative Care

  • Tube care, suctioning, humidification, and infection prevention.

Laryngeal Cancer Surgery (Partial/Laryngectomy)

Preoperative Preparation

  • Imaging (CT/MRI), biopsy, nutritional assessment.

Operation Details

  • Removal of part or all of the larynx depending on disease extent.

Post operative Care

  • Airway management, speech therapy referral, wound care.

Pharyngeal Procedures

Pharyngectomy (for cancer)

Preoperative Preparation

  • Imaging, biopsy, nutritional optimization.

Operation Details

  • Removal of affected pharyngeal tissue.

Post operative Care

  • Feeding tube may be needed, speech/swallow therapy, wound care.

Head & Neck Procedures

Submandibular Gland Excision and Removal of Stone from Submandibular Duct

Preoperative Preparation

  • Detailed medical history and physical examination by the surgeon.
  • Blood tests and other investigations if required.
  • Imaging (Ultrasound / CT scan) to confirm the size and location of the stone or gland problem.
  • Fasting for several hours before surgery, as instructed.
  • Consultation with the anesthetist regarding fitness for anesthesia.
  • Signing informed consent after discussion of procedure, risks, and benefits.

Operation Details

  • Type of Anesthesia: General or local anesthesia depending on the case.

Submandibular Duct Stone Removal:

  • A small incision is made inside the mouth.
  • The stone is carefully removed from the duct.
  • The duct may be widened to prevent recurrence.

Submandibular Gland Excision

  • A small incision is made in the upper part of the neck below the jawline.
  • The gland is carefully removed while preserving important nerves and blood vessels.
  • A small drain tube may be placed to prevent fluid collection.
  • The incision is closed with stitches.

Post operative Care

  • Pain, swelling, and mild discomfort are expected for a few days.
  • Painkillers and antibiotics are usually prescribed.
  • Maintain good oral hygiene and follow dietary instructions.
  • Avoid strenuous activity and heavy lifting until advised by the doctor.
  • Stitches are usually removed after 5–7 days (if non-absorbable).
  • Follow-up appointments are necessary for proper recovery.

Warning Signs Seek medical help immediately if you notice

  • Excessive bleeding or swelling.
  • High fever or pus from the wound.
  • Difficulty breathing or swallowing.
  • Weakness in tongue or lip movement.

Parotidectomy (Parotid Gland Surgery)

Preoperative Preparation

  • Complete medical history and physical examination.
  • Ultrasound / MRI / CT scan may be advised to check the size and location of the swelling.
  • Fine needle aspiration (FNAC) may be done to confirm the diagnosis.
  • Blood tests, ECG, and other investigations as required.
  • Fasting for several hours before surgery (as per anesthetist advice).
  • Detailed discussion with the surgeon about risks such as facial nerve weakness.
  • Consent form signed after understanding benefits, risks, and alternatives.

Operation Details

 

  • Surgery is done under **general anesthesia**.
  • An incision is made in front of the ear, extending downwards into the neck crease (cosmetic incision).
  • The gland is carefully separated from surrounding tissues.
  • The **facial nerve** and its branches are identified and preserved. 
  • Depending on the disease:
  • Superficial parotidectomy removal of the outer portion of the gland.
  • Total parotidectomy removal of the entire gland if needed.
  • A small drain tube may be placed to prevent fluid collection.
  • The incision is closed with fine stitches.

Post operative Care

  • Pain and swelling are common; painkillers and antibiotics are prescribed.
  • Drain usually removed after 24–48 hours.
  • Stitches removed after 5–7 days (if non-absorbable).
  • Avoid heavy exercise until advised.
  • Regular wound care and follow-up visits are essential.
  • Temporary facial weakness or numbness of ear/cheek may occur but often improves with time.

Warning Signs Contact doctor if you notice:

  • High fever, excessive swelling, or pus discharge.
  • Persistent facial weakness.
  • Severe bleeding or difficulty in breathing.

Thyroid Surgery (Thyroidectomy Hemithyroidectomy)

Preoperative Preparation

  • Detailed medical history and physical examination.
  • Ultrasound of the thyroid gland to assess nodules or swelling.
  • Blood tests including **thyroid function tests (T3, T4, TSH)**.
  • Fine needle aspiration (FNAC) or biopsy if required.
  • CT/MRI in selected cases.
  • ENT/endocrine surgeon consultation about risks and expected outcomes.
  • Vocal cord assessment (laryngoscopy) may be advised.
  • Fasting for several hours before surgery.
  • Consent after discussion about risks like voice change, calcium imbalance, and need for lifelong medication (in total thyroidectomy).

Operation Details

  • Surgery is done under **general anesthesia**.
  • A horizontal incision is made in a skin crease in the lower neck.
  • The thyroid gland (whole or part) is carefully dissected.
  • Important structures are preserved:
    • Recurrent laryngeal nerve:(controls vocal cords).
    • Parathyroid glands: (control calcium levels).
  • Types of surgery:
    • Hemithyroidectomy – removal of one lobe.
    • Total thyroidectomy – removal of the whole gland.
  • A small drain may be placed to prevent blood collection.
  • The wound is closed with fine sutures for cosmetic healing.

Post operative Care

  • Mild neck pain and swelling are common; painkillers and antibiotics are given.
  • Drain (if placed) is usually removed after 24–48 hours.
  • Stitches removed after 5–7 days (if non-absorbable).
  • Voice may feel weak or hoarse temporarily; usually improves with time.
  • Calcium levels may drop after total thyroidectomy → calcium supplements may be needed.
  • Thyroid hormone tablets may be started if the whole gland is removed.
  • Avoid heavy lifting and straining until cleared by the doctor.

Warning Signs Contact doctor if you notice

  • Severe neck swelling or difficulty breathing.
  • Persistent hoarseness or voice change.
  • Tingling/numbness in fingers or around mouth (low calcium).
  • High fever or pus discharge from wound.

Neck Dissection

Preoperative Preparation

  • Imaging and biopsy for lymph node assessment.

Operation Details

  • Removal of lymph nodes and surrounding tissue for cancer control.

Post operative Care

  • Drain care, physiotherapy, infection prevention.