Neck dissection

A neck dissection is performed to remove lymph nodes in the neck that have cancer cells.

Lymph nodes are small, bean-shaped structures that are part of your immune system. Sometimes, cancer spreads from a certain part of the body to its nearby lymph nodes. Oral and oropharyngeal cancers (cancers of the mouth and throat) frequently spread to the lymph nodes in the neck. Removing the lymph nodes may help stop cancer from spreading farther within the body and allow you and your care team to see whether more treatment is needed.

Your care team may perform a neck dissection during the same time as an excision, which is the removal of the tumor.

When doctors consider treatment options, they do their best to maintain function of other areas near the cancer itself, including:

• Nerves
• Organs
• Tissues

How it’s performed

The way a neck dissection is performed depends on the specific approach needed. Several types of neck dissection are available, depending on the cancer’s size and spread. These include:

• A partial or selective neck dissection removes a few lymph nodes nearest to the tumor.
• A modified radical neck dissection typically removes most of the lymph nodes on one side of the neck. Some muscle and nerve tissue also are removed. This is the most common type of neck dissection.
• A radical neck dissection removes almost all the lymph nodes on one side, from the jawbone to collarbone, as well as muscles, nerves and veins.

How to prepare for a neck dissection

There are a few things you may need to do before having a neck dissection to help you prepare.

• Inform your doctor of any medications you use, including pain relievers such as aspirin and ibuprofen, blood thinners like warfarin, and over-the-counter herbs and supplements. Find out which medications, if any, are OK to take on your surgery day, or whether you need to stop using them a few days prior.
• Discuss your alcohol use with your doctor. Too much alcohol may affect the results of the surgery.
• Don’t eat or drink after midnight before your surgery. If there are some medications you still must use, take them with a small sip of water.

Risks

A neck dissection has some common side effects, including:

• Ear numbness
• Swallowing problems
• Weakness when raising your arm above your head
• Weakness in your lower lip
• Wound healing problems

The weakness in your shoulder or lower lip may improve after a few months as your nerves heal. If the doctor removed a nerve because of its involvement with the cancer tumor, however, the weakness may be permanent. Physical therapy is often used to improve movement in your neck and shoulder after a neck dissection.

You may have to manage a temporary drain attached to your neck that keeps fluid from accumulating. This is usually needed for a few days. Your care team may provide instructions to manage the drain.

You may also want to watch out for signs of an infection, which is possible after any type of surgery. Alert your doctor if you have a fever above 100.5 degrees Fahrenheit, or if you have surgical wounds that are red or burning.

While managing any risks from a neck dissection, you may also have new side effects from the excision of the cancer itself. These risks and side effects include a loss of hearing and a change in your voice and speech. You also may have swelling near the throat that causes some problems with breathing.

Results

It’s possible to remove head and neck cancers when they’re identified early. As doctors plan the surgery, they also consider how it may affect you in other aspects of life, such as how you breathe, look and speak. Your care team may connect you with specialists to help you preserve your quality of life in these and other areas.