Neck Dissection

This surgery takes a systematic approach and it is generally performed as part of a treatment regimen for certain head and neck cancers. The lymphatic system in the human body is complex.

There are approximately 600 lymph nodes located throughout and about 200 are in the neck and head area. These nodes play an integral role in the immune system. They work by trapping and filtering infected material. The lymphatic system carries lymph fluid throughout the body. This fluid helps to fight infection due to the white blood cells that it contains.

When someone has cancer in the neck or head, it can spread to these lymph nodes. Neck dissection is a surgical procedure that can work to remove those already affected by cancer, or it can be used to remove the lymph nodes that have a good chance of being affected to reduce the risk of cancerous nodes. Removal can also help to prevent further metastasis since cancer in the lymph nodes can spread easily through the lymphatic system to various organs in the body.

In addition to removing certain nodes, nearby tissues might also be removed. Doctors can then use the removed nodes and tissue to analyze the cancer further. This can be helpful when working on an appropriate treatment regimen.

There are different techniques that surgeons can discuss with their patients. Depending on the cancer, one or more zones of lymph nodes might be removed. The techniques include:

• Modified radical neck dissection: This type involves removing less tissue because it leaves at least one of the surrounding tissues untouched.
• Radical neck dissection: This type is generally considered only when cancer has spread extensively. Several zones of lymph nodes are removed, as well as the sternocleidomastoid muscle, accessory new and internal jugular vein.
• Selective neck dissection: This type might be an option when the cancer is caught early. It preserves the most tissue by only removing select nodes.

No matter which technique is performed, patients are given general anesthesia so that they are able to sleep through the procedure. The incisions made, and how many are needed, depend on the location and how extensive the neck dissection will be.

After the surgery, patients may have a small drain to allow for the exit of fluid or blood that might otherwise start to build up in the space that was created when the lymph nodes and fat were removed. How long recovery takes depends on how extensive the surgery was and the patient’s overall health.

There are certain risks that patients should be aware of prior to having this surgery. These include:

• Hematoma and bleeding
• Infection
• Seroma
• Cervical or cranial nerve damage
• Chronic or recurrent facial swelling
• The Epstein-Barr virus
• Chyle leak
• Blood clots

Neck dissection can be done either electively or therapeutically. It is important to note that a patient’s ability to fight infection will not be altered following lymph node removal.