Neck Dissection

The extent of tissue removal depends on many factors including, the stage of disease which reflects the extent of cancer as well as the type of cancer. The most common cancers removed from lymph nodes in the neck include head and neck squamous cell carcinomas, skin cancers including melanoma and thyroid cancers.. In general, the goal of neck dissection is to remove all the lymph nodes within a predefined anatomic area. Many of the lymph nodes removed during surgery will not prove to have cancer in them.

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How is the procedure done?

Neck dissections are done under general anaesthesia through an incision that runs along a skin crease in the neck, extending vertically on the side of the neck. Incisions are usually designed to enhance the visualisation and protection of important structures in the neck, and enable the safe removal of lymph nodes that may contain cancer.

Beneath the skin, underlying fat, and a thin layer of muscle, the dissection proceeds to identify and remove the tissue containing the lymph nodes. If the procedure requires the removal of a muscle in the neck, there may be some flattening of the neck, but removal of this muscle rarely results in significant weakness.

What are some of the risks associated with this procedure?

Neck dissections are subject to numerous potential operative complications that are common to all operative procedures, as well as complications specific to this procedure.

Bleeding-Patients may bleed after an operation. Bleeding under the skin after a neck dissection is rare.
Infection can occur after any surgical procedure including neck dissection (uncommon)
Wound healing problems requiring additional surgery (rare)

Are there any nerves that may be damaged?

Several important nerves are found in the neck around the lymph nodes, and depending on the area of the neck to be operated, these nerves can be at risk for damage. The primary nerves of concern are-

The marginal nerve, a small branch of the facial nerve which controls lower lip movement
The spinal accessory nerve which aids in shoulder mobility and raising the arm over head
The hypoglossal nerve, which controls movement of the tongue (uncommon)
The lingual nerve, which controls sensation on the side of the tongue (rare)
The vagus nerve which controls movement of one vocal cord (rare)

Notify the RPS team immediately if you experience any of the following symptoms:

nausea, vomiting or diarrhoea
fever/high temperature – 38°C or higher
shortness of breath
leakage of blood or fluid after day one of recovery
increasing pain around the site
increasing redness around incision site
heavy bleeding from incision site.

What are some of the potential longterm problems that I need to be aware of?

Additional potential long-term problems include:

Incision- Most incisions heal well, but some individuals develop scars.
Numbness of the skin along the incision as well as over the cheek, ear and neck can be anticipated which improves with time; some long term numbness can be anticipated
Neck stiffness or pain
Long term swelling in the neck or lymphedema
Shoulder weakness (uncommon)
Changes in speech and swallowing (rare)

Some problems are attributable to nerve injury; more commonly, scarring under the skin from surgery and radiation contributes to disability. Some problems may be avoided with early and faithful adherence to a shoulder range of motion exercise program, lymphedema or speech therapy rehabilitation programs.

How will the RPS team manage my post-operative care?

RPS will give you specific advice regarding your individual post-operative recovery. They will advise:

where you will go after your surgery
what medication you will be given or prescribed
what bandages and dressings you will need and when they’ll be removed
if you require stitches, when they’ll be removed
when you can get back to normal activity and exercise
when to book your follow-up care.

Dr. Michael Findlay

Our Melbourne specialist

The team at RPS Melbourne are committed to providing you with the best possible outcome.

The extensive specialist skills of our surgical team ensure that you are provided with surgical options designed to maximise form and function.

Dr Michael Findlay holds an impressive array of academic credentials, extensive professional experience and a personal commitment to patient satisfaction.

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