Dr James Briffa1
1Launceston General Hospital, , Australia
A 68-year-old female presenting with a tissue confirmed squamous cell carcinoma of the parotid gland underwent a left sided parotidectomy and neck dissection. The procedure was performed without issue and the patient was discharged day three post-operatively. At the one-week post-operative review, it was noted that the patient had sustained a deep tissue injury to her left ear, unbeknownst to the patient. On further inspection this tissue injury was identified as a mid-dermal burn. On enquiry it was uncovered that the patient had been experiencing altered sensation in the distribution of the greater auricular nerve since discharge and had been placing a heat pack to this area in an effort to alleviate the symptoms. On review of the operative note, it was found that the greater auricular nerve had been retracted for an extended period of time throughout the procedure.
Heat packs have long been identified as a common source of iatrogenic contact thermal injury (Mun et al., 2012). This case serves to highlight that post-operative sensory disturbance is not always immediately apparent and demonstrates the importance of thorough screening for cutaneous sensory disturbance in this cohort. In addition, the importance of education in preventing burn injuries in post-operative patients is also emphasised.
Mun, J., Jeon, J., Jung, Y., Jang, K., Yang, H., Lim, H., Cho, Y., Kim, D., Hur, J., Kim, J., Chun, W. and Seo, C., 2012. The Factors Associated with Contact Burns from Therapeutic Modalities. Annals of Rehabilitation Medicine, 36(5), p.688.
Dr James Briffa is a Unaccredited Plastic and Reconstructive Surgery Registrar at the Launceston General Hospital. He has an interest in all fields of reconstructive surgery in addition to military and medical history.