Neck dissection is a surgical procedure used to remove cancer that has spread to the lymph nodes in the neck.
Lymph nodes are small, bean-shaped glands scattered throughout the body. These glands filter and process lymph fluid from other organs, which helps the body fight infections.
Neck dissection involves removing lymph nodes and surrounding tissue from the neck. Head and neck squamous cell carcinomas, thyroid cancer, and skin cancers including melanoma are common forms of cancer that may require a neck dissection. The surgery removes the lymph nodes in a predefined anatomic area. The extent of tissue removal depends on factors such as the type of cancer and the stage of the disease.
The Procedure
Neck dissections are done under general anesthesia. An incision is made along the skin crease of the neck — extending vertically on the side of the neck. The incision improves visualization and protection of important structures in the neck, making it safe to remove the lymph nodes that are cancerous.
Post-Surgery Risks
Neck dissections have several potential operative complications that are common to many types of procedures. There are also numerous complications specific to neck dissections.
Bleeding — Bleeding under the skin after a neck dissection is rare. However, a procedure to remove the blood may be required if this happens. Rarely, a blood transfusion is also needed.
Infection — Infection is typically an uncommon risk associated with a neck dissection though it can occur.
Chyle Leak — Chyle leak is caused by fluid accumulation in the neck from the disruption of the thoracic duct. This is another rare risk with this type of surgery though it is more common for left-sided neck dissections.
Wound healing problems are rare but can require additional surgery.
Because there are several important nerves in the neck around the lymph nodes, there is a chance these nerves could be damaged during the surgery. Below are the nerves of concern:
· The marginal nerve, which is a small branch of facial nerves that controls lower lip movement
· The hypoglossal nerve, which controls the movement of the tongue (an uncommon concern)
· The spinal accessory nerve, which aids in shoulder movement and raising the arm over the head
· The vagus nerve, which controls the movement of one vocal cord (rarely a concern)
· The lingual nerve, which controls sensation on the side of the tongue (rarely a concern)
Some potential long-term issues include:
· Neck stiffness or pain
· Long-term swelling in the neck or lymphedema
· Shoulder weakness (an uncommon side effect)
· Scarring at the incision site
· Changes in speech or swallowing (a rare side effect)
· Numbness of the skin along the incision and over the cheek, ear, and neck. This can improve with time.
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