Complications in head and neck surgery and how to avoid trouble.

Increasing litigation in recent years has made it more and more necessary for the surgeon to be aware of the problems, pitfalls and complications which may arise as a result of surgery. The risks are compounded in the head and neck not only because of its complex anatomy but also because of additional difficulties relating to surgery of the upper aero-digestive tract. Some problems are unavoidable. The potential risks of surgery and its complications should be carefully weighed against the natural history of the pathological process and a realistic expectation of the surgical outcome compared with alternative treatments. Other problems may result from genuine mistakes, but a number of complications are caused through actions or omissions which are avoidable and which in certain circumstances may be construed as professional negligence. Some of the more common pitfalls and complications in head and neck surgery are discussed with particular reference to their causation and possible avoidance.