Neck Dissection (Removal of Neck Lymph Nodes)

Neck dissection is a surgical procedure in which the lymph nodes in the neck are removed as a whole. These nodes play an essential role in our immune system’s defense against infections and diseases. However, in conditions such as cancer, lymph nodes can become pathways for the disease to spread throughout the body. This is where neck dissection becomes necessary.

Why Is Neck Dissection Needed?

Lymph nodes can serve as sites for cancer cells to settle and multiply. Neck dissection is typically performed for the following reasons:

Diagnosing cancer: To determine whether cancer is present in the lymph nodes.
Controlling the disease: To reduce the risk of cancer spreading.
Completing treatment: To remove remaining cancerous tissues after radiotherapy or chemotherapy.
Preventing recurrence: To minimize the chances of the disease returning.

In head and neck cancers, this surgery is a critical step for both treatment and staging the disease.

How Is the Surgery Performed?

Neck dissection is performed under general anesthesia. During the procedure, the surgeon makes an incision in the neck and removes the lymph nodes. The extent of the surgery depends on the spread of the disease:

1) Selective Dissection: Only the lymph nodes most likely to be affected by cancer are removed.

2) Modified Radical Dissection: A wider area is cleared, but some muscles and nerves are preserved.

3) Radical Dissection: Nearly all the lymph nodes on one side of the neck are removed, and sometimes muscles, blood vessels, and nerves may also be taken out.

A drainage tube is placed in the surgical area to prevent fluid buildup during the healing process. This tube is typically removed after a few days.

Postoperative Recovery

You will usually need to stay in the hospital for a few days after surgery. During this time, doctors will closely monitor your recovery and provide the following recommendations:

Pain and infection management: Antibiotics and painkillers will be prescribed.
Wound care: Instructions will be given on how to clean and protect your stitches.
Exercise suggestions: Light exercises may be recommended to restore neck and shoulder mobility.

Possible Side Effects

Some side effects may occur after neck dissection. While most are temporary, some can be permanent:

Bleeding: Minor bleeding under the tissue may occur.
Swelling (Lymphedema): Fluid accumulation in tissues can lead to swelling.
Stiffness in the neck or shoulder: Limited mobility may be experienced.
Infection: Redness, pain, or inflammation at the wound site.
Fluid accumulation under the skin (Seroma): Fluid may collect near the incision site.
Cosmetic changes: Changes in the appearance of the neck and skin may occur after surgery.
Restricted shoulder movement:

Your doctor will guide you on managing these side effects, such as special massage techniques for lymphedema or drainage procedures for fluid accumulation.

Outcomes of the Surgery

The lymph nodes removed during neck dissection are examined pathologically. These results play a significant role in planning further treatment:

Negative result: If no cancer cells are found, it means the disease has not spread to the lymph nodes.
Positive result: If cancer cells are detected in the lymph nodes, further treatment may be required.

The results of the surgery are used to determine the stage of cancer and decide on the next course of treatment. Your doctor will guide you through this process.

Neck dissection is an important step in controlling the disease and planning treatment. If this surgery has been recommended, do not hesitate to discuss all the details with your doctor. Being informed about each stage of the process can help you feel more comfortable.