Understanding Neck Dissection

Neck dissection is done when cancer has spread to nearby lymph nodes in the neck. Your healthcare provider may use imaging tests or a biopsy to confirm that cancer is there. Or they may remove the lymph nodes because they are close to the main tumor and likely to be affected. Lymph nodes may be removed from one or both sides of the neck.

There are different types of neck dissection. The kind you have will depend on how big the tumor is and how far it has spread. Your surgery may be:

• Partial or selective. During this type, the surgeon takes out only a few lymph nodes. These are often the ones closest to the tumor.
• Modified. The surgeon removes most of the lymph nodes. They may also take out some muscle tissue and nerves.
• Radical. The surgeon removes almost all the lymph nodes in the neck. They also take out larger amounts of surrounding tissue, such as muscles, nerves, and veins.

Your healthcare provider will talk with you about this surgery. They will also examine you.

To help get ready for this surgery:

• Tell your healthcare provider what medicines you take. Include both prescription and over-the-counter medicines. Also include vitamins, herbs, and supplements.
• Have any tests your provider asks for, such as blood tests or imaging tests.
• Quit smoking, if you smoke. Smoking can slow healing after surgery. Ask your provider for resources to help you quit.
• Follow any directions you're given for not eating or drinking before your surgery.

Before the surgery, you'll be asked to sign an informed consent form. Signing the form means you understand and agree to have the surgery. Be sure all your questions are answered before you sign the form.

This surgery takes place in a hospital. During it:

• An IV (intravenous) line will be put into a vein in your arm or hand. It's used to give you fluids and medicine to prevent pain.
• You will get general anesthesia. This puts you into a deep sleep during the surgery.
• The surgeon will make a cut (incision) down the side of your neck.
• They will remove as many lymph nodes as needed. They may remove surrounding tissue, such as muscles, nerves, and veins, depending on the extent of your cancer.
• Once finished, they will close the incision with stitches.
• The surgeon may place a small tube (drain) in your neck. This drain removes any excess blood or fluid. It may stay in place for a few days after the surgery.

You’ll be taken to a recovery room to rest. You’ll be given medicines to help manage pain and prevent infection. You may stay in the hospital for several days.

Your healthcare provider will tell you when it’s OK for you to go home. They will give you instructions on how to care for yourself. Follow all instructions for eating, bathing, activity, pain control, and care of your incision and drain (if you go home with one). Take all medicines as directed.

You will have to see your healthcare provider regularly for check-ups. You may have imaging tests to make sure the cancer hasn’t come back. Keep all follow-up visits with your provider. Talk with your provider if you have any questions or concerns.

Your provider may advise physical therapy. It can help you regain strength and movement in your neck and shoulder muscles. If you have problems swallowing, you may also see a speech-language therapist.

All procedures have risks. Your healthcare provider will talk with you about the risks and benefits. Be sure to ask any questions you have. The risks of this surgery include:

• Bleeding
• Blood clots
• Infection
• Nerve damage, causing weakness in the lower lip or shoulder
• Numbness around the surgery site
• Neck pain or stiffness
• Problems eating, breathing, or speaking
• Changes in how your neck looks
• Problems related to anesthesia

Call 911 if you have:

• Shortness of breath
• Trouble breathing
• Chest pain

Call your healthcare provider if any of these occur:

• Fever of 100.4°F (38.0°C) or higher, or as directed by your provider
• Chills
• Redness or swelling of the surgery site
• Leaking fluid or a bad smell from the surgery site
• Pain that gets worse
• Problems with the stitches or drain
• New or increased bleeding