ACCREDITED CPD - SURGERY
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Once the patient is mobile, alert and preferably eating in
hospital I will look to change them onto oral pain medication and send them home. These patients have often
been on corticosteroids and hence one should be careful with non-steroidals for pain. If there has been no corticosteroid use in the last 5 days they can be discharged
on NSAIDs and oral tramadol.
A buster collar is placed to stop the patient scratching
at the wound. If a drain is placed then the head should
be bandaged until the drain is removed. This bandage
needs to be changed every 24 to 48 hours till the drain
is removed.
Complications
The complication rates with a TECA BO are high. Intraoperative haemorrhage is the most common complication, which could be fatal if not managed. However the
haemorrhage is usually insignificant and hampers the
surgeon’s ability to see during surgery more than anything else.
The reported incidence of permanent facial nerve damage is 31% this can be from transection of the facial nerve
as it exits the stylomastoid foramina, or severe neurontometesis (traction injury) from inappropriate retract [ۂ