Neck Dissection

Neck dissection surgery is performed to examine and remove the lymph nodes in the neck.

The three types of neck dissection surgery are:

• Radical neck dissection involves removing all the tissue on the side of the neck from the jawbone to the collarbone; includes the muscle, nerve, salivary gland and major blood vessels in this area.
• Modified radical neck dissection involves removing all lymph nodes, but spares the nerves in the neck and, sometimes, the blood vessels and muscle; compared to radical neck dissection, less neck tissue is taken out
• Selective neck dissection involves removing a few lymph nodes and possibly saving the muscle, nerve and blood vessel in the neck

Patients with cancer that has spread to the lymph nodes may need a neck dissection to prevent cancer from spreading to other parts of the body.

A physician may recommend the procedure if the patient has:

• Cancer of the mouth, tongue, thyroid gland or other areas of the throat or neck
• Cancer that has spread to the lymph nodes
• Cancer that may spread to other parts of the body

The potential risks of anesthesia and the procedure include:

• Allergic reactions to medicines
• Breathing problems
• Bleeding
• Infection
• Numbness in the skin and ear on the side of the surgery, which may become permanent
• Damage to the nerves of the cheek, lip, and tongue
• Difficulty lifting the shoulder and arm
• Limited neck movement
• Drooping shoulder on the side of the surgery
• Difficulty talking or swallowing
• Facial droop

Patients should discuss the following with their physician before the procedure:

• If they are or could be pregnant
• Medication, vitamins, herbs and supplements they may be taking
• If they consume more than one or two alcoholic drinks per day

A few days before the procedure, patients will be asked to stop taking ibuprofen (Advil, Motrin), aspirin, naproxen (Aleve, Naprosyn), clopidogrel (Plavix), warfarin (Coumadin) and any other medications that may make it difficult for the blood to clot.

Patients should not eat anything after midnight the night before their surgery, but may drink up to 12 ounces of water between midnight and up until two hours before surgery.

The patient will be taken to the recovery room where they will wake up after surgery. The head of their bed will be slightly raised and they will have an IV set up for fluids and nutrition. The patient’s body temperature, pulse, blood pressure and oxygen levels will be monitored.

Patients will not be able to eat or drink for the first 24 hours. Pain medication and antibiotics will be provided to alleviate pain and the patient will have drains in their neck to help prevent fluid from collecting under the skin.

Some patients may start physical therapy while they are in the hospital. Patients are typically discharged in two to three days and should follow up with their provider in seven to 10 days.