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Neck Dissection

Definition

Neck dissection is surgery to remove the lymph nodes and surrounding tissue in the neck. There are 3 types of neck dissection:

  • Radical neck dissection—removes neck tissue, lymph nodes, muscle between the collarbone and jawbone, the internal jugular vein, and muscles and nerves that control speech, swallowing, and movement in the face, neck, and shoulder
  • Modified radical neck dissection—removes lymph nodes, but preserves some nerves, blood vessels, and/or muscles
  • Selective neck dissection—removes less lymph nodes and tissue, and preserves nerves, blood vessels, and muscles
Lymph Nodes
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Reasons for Procedure

This procedure may be done to remove neck and throat cancers or to prevent some cancers of the head from spreading after the cancer has been removed. It may also be done to remove a lymph node for biopsy.

Possible Complications

All procedures have some risk. Your doctor will review potential problems, like:

  • Adverse reaction to anesthesia
  • The effects of removing nerves, blood vessels, and muscles
  • Infection
  • Blood clots
  • Excess bleeding
  • Nerve damage
  • Blood vessel damage
  • Damage to the lymph channels, causing leakage
  • Chronic pain from nerve damage

Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:

  • Smoking
  • Drinking
  • Chronic disease such as diabetes or obesity

What to Expect

Prior to Procedure

Leading up to your procedure, you will need to:

  • Have lab tests done as advised by your doctor
  • Have images taken of your bodily structures, such as an ultrasound,CT scan, or MRI scan
  • Have the electrical activity and health of your heart checked with an EKG
  • Arrange for a ride home from the hospital.
  • Talk to your doctor if you take any medications, herbs, or supplements.
  • You may need to stop taking some medications up to one week before the procedure.
  • Avoid eating after midnight the night before your procedure.

Anesthesia

You will be given general anesthesia through an IV. It will block pain and keep you asleep through the surgery.

Description of Procedure

An incision will be made on the side of your neck. The selected tissue will be identified and carefully separated from tissue that will remain. Lymph nodes and selected tissue will then be carefully removed. If you are having a radical neck dissection, the jugular vein, muscles, and nerves will also be removed.

Drains may be placed to prevent fluid buildup in the area. The incision is closed with stitches and covered with a dressing.

Immediately After Procedure

After the operation, you will be taken to the recovery room for observation. You may be monitored in the intensive care unit overnight.

How Long Will It Take?

2-3 hours

How Much Will It Hurt?

You will have some pain after the procedure. Ask your doctor about medication to help with the pain.

Post-procedure Care

At the Care Center

Right after the procedure, the staff may:

  • Give you fluids by IV
  • Give you pain medication
  • Encourage you to eat a liquid diet and progress to your regular diet
  • Raise the head of your bed to decrease swelling
  • Remove any drains that were inserted during surgery

Your length of stay will depend on how much tissue was removed and what symptoms you may be experiencing. Most people are able to leave the care center the day after surgery.

During your stay, the hospital staff will take steps to reduce your chance of infection, such as:

  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incisions covered

There are also steps you can take to reduce your chances of infection, such as:

  • Washing your hands often and reminding visitors and healthcare providers to do the same
  • Reminding your healthcare providers to wear gloves or masks
  • Not allowing others to touch your incisions

At Home

When you return home:

  • Protect your scar with sunscreen with an SPF of 30 or higher to promote healing and improve its appearance
  • You may have numbness in your neck, face or head.
    • It may go away on its own after a few months, or it may become permanent depending on the work that was done in your neck.
    • Be aware that areas of skin that are numb are more vulnerable to heat or cold.
  • You may be referred to a physical therapist to improve muscle and nerve function that lingers.
  • You may be referred to a speech therapist to improve communication if your vocal cords were affected by the surgery.

Call Your Doctor

Contact your doctor if your recovery is not progressing as expected or you develop complications, such as:

  • Signs of infection, including fever and chills
  • Redness, swelling, increasing pain, excessive bleeding, or any discharge from the incision site
  • Numbness or tingling of your fingers or around your mouth
  • Difficulty breathing
  • New or worsening symptoms

If you think you have an emergency, call for emergency medical services right away.

Revision Information

  • American Cancer Society

    http://www.cancer.org

  • National Cancer Institute

    http://www.cancer.gov

  • Canadian Cancer Society

    http://www.cancer.ca

  • Health Canada

    http://www.hc-sc.gc.ca

  • Description of a neck dissection (removal of the lymph nodes in the neck). Eastern Virginia Medical School website. Available at: https://www.evms.edu/patient%5Fcare/services/ent/patient%5Feducation/head%5F%5Fneck%5Fsurgery/description%5Fof%5Fa%5Fneck%5Fdissection%5Fremoval%5Fof%5Fthe%5Flymph%5Fnodes%5Fin%5Fthe%5Fneck. Accessed February 25, 2015.

  • ENT surgery. MedStar Health website. Available at: http://www.medstarhealth.org/mhs/our-services/surgery/treatments/ent-surgery/#q={}. Accessed February 25, 2015.

  • Neck dissection. Cedars-Sinai website. Available at: http://www.cedars-sinai.edu/Patients/Programs-and-Services/Head-and-Neck-Cancer-Center/Treatment/Neck-Dissection.aspx. Accessed February 25, 2015.

  • Neck dissection. Northwest ENT Associates website. Available at: http://www.nwentassociates.org/Neck-Dissection.asp. Accessed February 25, 2015.

  • Radical neck dissection. Florida Hospital website. Available at: https://www.floridahospital.com/radical-neck-dissection. Accessed February 25, 2015.