Surgery for head and neck cancers may affect the patient’s ability to chew, swallow, or talk. The patient may look different after surgery, and the face and neck may be swollen. The swelling usually improves with time. However, if lymph nodes are removed, the flow of lymph in the area where they were removed may be slower and lymph could collect in the tissues (a condition called lymphedema), causing additional swelling that may last for a long time. 

Head and neck lymphedema may be visible or internal. In most cases, it can be reversed, improved, or reduced if treated promptly. Patients with untreated lymphedema may be more at risk of complications such as cellulitis, or an infection of the tissues. Untreated cellulitis, if severe, can be dangerous and could lead to further swallowing or breathing difficulties.

After a laryngectomy (surgery to remove the voice box) or other surgery in the neck, parts of the neck and throat may feel numb because nerves have been cut. If lymph nodes in the neck were removed, the shoulder and neck may become weak and stiff. 

Patients who receive radiation to the head and neck may experience side effects during and for a short while after treatment, including redness, irritation, and sores in the mouth; a dry mouth or thickened saliva; difficulty in swallowing; changes in taste; or nausea. Radiation may also cause loss of taste, which may decrease appetite and affect nutrition, and earaches (caused by the hardening of ear wax). Patients may also notice some swelling or drooping of the skin under the chin and changes in the texture of the skin. The jaw may feel stiff, and patients may not be able to open their mouth as wide as before treatment.

Although side effects will improve slowly over time in many patients, others will experience long-term side effects of surgery or radiation therapy, including difficulty swallowing, speech impairment, and skin changes (33). 

Patients should report any side effects to their doctor or nurse and discuss how to deal with them.