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Selective neck dissection swelling problem

yensid683's picture
Posts: 320
Joined: Apr 2012

Anyone out there experience swelling several weeks after their surgery?

I had a selective dissection 5 weeks ago, was healing well but started swelling three days ago, large obvious areas along the incision site, the left side of my neck,and under my chin. Red, warm to the touch, some areas are hard, some soft, but no fever.

I contacted my ENT and was advised to go to the ER as there may be a bleed. CT shows a 'mass' but the radiologist cannot identify it, some type of fluid or 'hypodensity'. Tests for an infection were negative, and I was sent home with a broad spectrum anti-biotic.

Things seem slightly better today, but I have odd tingling in my left arm, pain in my neck, the teeth in the left side of my mouth, and a feeling of congestion on the left side of my face as well as pitting edema under my chin. My 'turkey wattle' from rads can be gently pushed on and you can feel the fluid move, just like deflating a pool toy!

Have any of our family experienced anything like this? I'm seeing the ENT on Monday and right now I'd like nothing more than to relieve the pressure feeling.

longtermsurvivor's picture
Posts: 1845
Joined: Mar 2010

that you have a collection of fluid there. That collection will either be from a bleed or from pus. Your lack of fever suggests but does not prove that this isn't infective in origin. But if it is infective, the lack of fever indicates you have successfully walled it off and are at no real risk. Whatever is under the skin will drain. Either spontaneously or with assistance from the ENT. The treatment for now is to put lots of heat on it. Sit around with a heating pad if possible. I had this happen after my radical resection and reconstruction. Had a low grade fever for a few evenings after surgery, which then went away. Drained a small abscess under my chin about a week later. Kind of gross, but no big deal. If you had to chose between waiting on your ENT or going to the ER to have this attended, chose the ENT. The ER likely doesn't have much skill at this.



yensid683's picture
Posts: 320
Joined: Apr 2012

I had no problems in the first 5 weeks post op, some morning swelling but that comes with the lymph node and plumbing removal. This showed up suddenly.

the ER had two potential diagnosis, neck trauma (I was seen by an oral surgeon a few days earlier who thoroughly examined my jaw and neck for lymph nodes) and they thought it possible that it may have been a bleed. CT for venous mapping was done and was inconclusive.
They also thought that cellulitis was possible, and prescribed 500 mg Keflex 3 times a day. two doses in but no change yet. I'm hoping the ENT will do better Monday, super cramps and muscle pain, but specifically told NOT to take anything other than OTC analgesics

I'll see what the heating pad might do. Ice on Thanksgiving Day did not make any impression


Grandmax4's picture
Posts: 712
Joined: Dec 2011

lymph nodes removed...the yuck has to find a new route to leave your body..mine's still looking and it's been a year..hate the turkey neck, thought someone might grab me up for their Thanksgiving dinner...massage helps a little, small circles from chin to ear..just takes time

yensid683's picture
Posts: 320
Joined: Apr 2012

with their associated piping and I was aware of the new drainage challenges. I've taken to sleeping with my head elevated on multiple pillows and it does help. I had one occasion when I fell asleep on the sofa with just one pillow and the fluid accumulation was impressive, but drained away after an hour or so. This is well beyond that, picture smuggling grapefruits in the turkey neck. I can massage the bulge and it moves. I can lightly press on it and actually feel it drain, much like squeezing frosting out of an icing bag. Feels very strange and I have to think it a bad thing to do.

My ENT did discuss the possibility of swelling, but when I described this yesterday, he was more than a little concerned.

What was the name on that brain you brought?

Abbie something, that's right, Abbie-Normal......

ratface's picture
Posts: 1320
Joined: Aug 2009

Do not be afraid to massage the area. The touch is very light and you want to stroke the area almost as if you were petting a cat very lightly. Begin the massage on the inside of your thigh starting in the groins and stoking down. Then move up the body on the affected side stroking toward the groins. Lastly move to the neck bulge and stroke this into the now cleared area. You may also roll a tennis ball with extreme light pressure on the spot, rolling down the neck and into the shoulder and then continue down into the groins again. Picture a slinky. You always want to clear an area then flip the slinky into the cleared area. Whatever type of fluid it may be will benefit from massage. The massage is extremely light in nature, you only affect the very top layer of tissue, barely noticeable or perceived by the body.

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