BENEFITS AND RISKS OF NECK MASS EXCISION & BIOPSY
INTRODUCTION
Your child has been offered surgery for removal of a mass or lump in the head or neck. As has been
discussed by your physician, other treatment modalities (including watchful waiting, needle biopsy,
medication) are available and are either not appropriate in your child’s case or has been ineffective in the
past.
BENEFITS OF SURGERY
The purpose of this procedure is to remove the mass to determine what it is and to see if additional
treatment will be needed.
RISKS OF NECK MASS EXCISION & BIOPSY INCLUDE, BUT ARE NOT LIMITED TO:
The potential risks of this procedure include, but are not limited to bleeding, infection, poor healing, nerve
injury, and need for further surgery.
Additional risks discussed include____________________________________________________.
It is anticipated that your child’s recovery will be sage and uneventful. However, it is essential that you
understand these benefits and risks.
I have been given a copy of the risks and benefits of surgery and have had the opportunity to ask
questions.
_________________________________
Patient
Date
___________________________________
Parent/Guardian
Date
__________________________________
Witness
Date
____________________________________
Surgeon
Date
SHARED/BENEFITS/RISKSNECK MASS EXCISION & BIOPSY
September 17, 2014
3580 Sheridan Drive, Suite 115
Amherst, NY 14226
(716) 362-9730
www.wnykidsent.com