Neck Dissection
Definition
Neck dissection is surgery to remove the lymph nodes and surrounding tissue in the neck. There are three types:
- 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 muscles
- Selective neck dissection—removes less lymph nodes and tissue, and preserves nerves, blood vessels, and muscles
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Reasons for Procedure
This surgery 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
Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:
- Excess bleeding
- Problems from anesthesia, such as wheezing or sore throat
- Infection
- Blood clots
- Damage to nearby organs or structures
Things that may raise the risk of problems are:
- Smoking
- Chronic diseases, such as diabetes or obesity
- Alcohol use disorder
What to Expect
Prior to Procedure
The surgical team may meet with you to talk about:
- Anesthesia options
- Any allergies you may have
- Current medicines, herbs, and supplements that you take and whether you need to stop taking them before surgery
- Fasting before surgery, such as avoiding food or drink after midnight the night before
- Arranging for a ride to and from surgery
- Tests that will need to be done before surgery, such as images of the neck
Anesthesia
General anesthesia will be used. You will be asleep.
Description of Procedure
An incision will be made on the side of the neck. The selected tissue will be identified and separated from tissue that will stay. Lymph nodes and selected tissue will then be removed. A person having a radical neck dissection will also have the jugular vein, muscles, and nerves removed.
Drains may be placed to prevent fluid buildup in the area. The incision is closed with stitches and covered with a bandage.
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 to 3 hours
Will It Hurt?
Pain and swelling are common in the first week. Medicine and home care can help.
Average Hospital Stay
The usual length of stay is a 2 to 3 days, but it depends on the reason for surgery. If you have any problems, you may need to stay longer.
Post-procedure Care
At the Hospital
Right after the procedure, the staff may:
- Give you medicine to treat pain
- Remove any drains that were inserted
During your stay, staff will take steps to lower your chance of infection, such as:
- Washing their hands
- Wearing gloves or masks
- Keeping your incisions covered
You can also lower your chance of infection by:
- Washing your hands often and reminding visitors and staff to do the same
- Reminding staff to wear gloves or masks
- Not letting others touch your incisions
At Home
Activities will be limited during recovery. It will take a few weeks to heal. Some numbness and weakness may take many months to go away.
Call Your Doctor
Call your doctor if you are not getting better or you have: :
- Signs of infection, such as fever and chills
- Redness, swelling, increasing pain, excessive bleeding, or any discharge from the incision
- Numbness or tingling of your fingers or around your mouth
- Problems breathing
- New or unexpected symptoms
If you think you have an emergency, call for medical help right away.
RESOURCES:
American Cancer Society
https://www.cancer.org
National Cancer Institute
https://www.cancer.gov
REFERENCES:
Argiris A, Karamouzis MV, et al. Head and neck cancer. Lancet. 2008 May 17;371(9625):1695-1709.
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_care/specialties/ent_surgeons/services/head__neck/patient_education/description_of_a_neck_dissection_removal_of_the_lymph_nodes_in_the_neck. Accessed August 19, 2020.
ENT surgery. MedStar Health website. Available at: https://www.medstarhealth.org/mhs/our-services/surgery/treatments/ent-surgery/#q={}. Accessed August 19, 2020.
Management of head and neck cancer. EBSCO DynaMed website. Available at: https://www.dynamed.com/management/management-of-head-and-neck-cancer. Accessed August 19, 2020.
Neck dissection. Cedars-Sinai website. Available at: https://www.cedars-sinai.org/programs/cancer/we-treat/head-and-neck/treatments/dissection.html. Accessed August 19, 2020.
Last reviewed March 2020 by EBSCO Medical Review Board James P. Cornell, MD Last Updated: 8/19/2020