What is a neck dissection?

A neck dissection is a surgical procedure to remove lymph nodes and surrounding tissues that contain cancer on one or both sides of the neck. There are three types of neck dissection surgery:

• Selective neck dissection — if the cancer hasn’t spread too far, then not all the lymph nodes will need to be removed. During this type of surgery, the blood vessels, muscles, nerves and surrounding tissues are conserved.
• Modified radical neck dissection — all the lymph nodes are removed during this procedure. Some neck tissue will need to be removed but the surgeon might be able to spare the nerves, blood vessels and muscle.
• Radical neck dissection — All the tissue on one side of the neck is removed; from the jawline to the collarbone, including the muscle, blood vessels and nerves.

Why is a neck dissection performed?

If you have mouth cancer, thyroid cancer or cancer in other areas of the throat or mouth, then a doctor may suggest you undergo this surgery. This is because, in certain types of cancers, cancer cells can travel with white blood cells in the lymph system to other parts of the body. Cancer in the mouth or throat can travel to the lymph nodes in the neck and get trapped there. To prevent the cells from spreading further, the lymph nodes need to be removed.

Before the procedure

The days before your surgery, you will need to stop taking certain medicines, especially blood-thinning medications. You should always ask your doctor which medications are and aren’t safe to continue taking.

On the day before surgery, you won’t be able to eat or drink anything and you should follow all the instructions given to you by your doctor. Right before surgery, you will be given a general anaesthetic, which will make you go to sleep so you can’t feel any pain during the operation.

During the procedure

The specialist surgeon will make a large incision in the neck to access the lymph nodes. The incision usually starts under the chin, towards the collarbone and then ends behind the ear. Once the surgeon has access to your lymph nodes, they will remove them and any surrounding tissue that contains cancer and then close the flap of skin with stitches or clips.

After the procedure

You will wake up in the recovery room after surgery, likely with a tube in your vein to give you fluid and nutrition. You will also have drains in your neck and need to take antibiotics and painkillers. Discomfort is expected for the first few days but it should completely disappear in about 2 weeks.

Usually, patients can go home from the hospital after 2-3 days and have a follow-up visit 7-10 days later.

What are the risks?

As with any operation, there are always potential complications. However, with this type of surgery, they are rare. Nerve damage is one of the most common complications, such as damage to the accessory nerve or a facial nerve, which can result in pain and sometimes weakness in that area. Usually, nerve damage can get better on its own but it may take several months to properly heal.