I was thinking the pec flap was placed in the neck after the neck dissection. That's where mine is, and I heard of the surgery you described for the tongue, but mine was oropharyngeal cancer to the lymph nodes. Everyone is different. I didn't need PT from surgery until I had a few of them, but it still wasn't that bad compared to needing PT from chemo. Now I have a few issues that are related to all the treatments I had, and need PT again.

I had no issues with the jugular vein removal a few years ago, but possibly with the vagus nerve, carotid artery removed last year, and whatever other nerves possibly removed like the accessory, phrenic nerve. Really not sure anything can be pinpointed to blame since I had a number of radiation treatments, and surgeries, and just in the diagnostic phases.

See where it goes once discharged. So many things may or may not occur, but the doctors and his health team are best right now for information, treatment and guidance, and of course your support. I didn't have a trach, so I'm not familiar with it, other than sharing pain, which needs to be addressed, and can interfere with healing.

If the doctors say "He won't need it because he has the other side" assuming he carotid artery, later on you want it to keep the other side working, which may entail diet, medications, imaging studies and surveillance, but again, we may be talking about a different area than mine.

Good luck