How do you manage postoperative head and neck cancer patients who have difficulty completing simulation due to copious secretions?   

In addition to elevating the head/shoulders as much as technically feasible, if there aren't contraindications, I've used a scopolamine patch applied two days before the sim with variable success.

Use a wedge to elevate the head and shoulders.

For the general problem of excessive secretions, some options to consider include: scopolamine, glycopyrrolate, and atropine drops under the tongue. 

In addition to medical management such as scopolamine (which I have found to be helpful), we have used a suction machine that patients or caregivers may use prior to and after treatment. Having the machine available may help with the anxiety that can be part of this. Even using a nasal cannula can h...