Neck Dissection

Head and neck malignancies typically spread to the lymphatic system before spreading to any other part of the body. The timely removal of the cancerous lymph nodes thus becomes crucial to prevent their spread. Neck cancer, being one of the common types of head and neck malignancies, is a meticulous surgical procedure and should be performed by a skilled surgeon to improve the success rates. Choosing a credible healthcare institution is therefore paramount.

Neck Dissection is a surgical procedure performed to remove cancerous lymph nodes from the neck region to prevent the spread of cancer cells. A neck dissection surgery is generally suggested to patients with head and neck cancers, including nearby organs like the thyroid gland, the larynx, the oral cavity, and the salivary glands. 

Neck Dissection can be a minor surgery or an extensive procedure, depending on the cancer location, type, and stage. Modern versions of neck dissection surgery try to strike a balance between the two by eliminating the cancer cells while also preserving the healthy tissues.

There are several types of neck dissection procedures, as discussed below. The classification is generally performed based on the extent of tissue removal. 

• Radical Neck Dissection - Involves the removal of complete lymph nodes only on one side of the neck. This type of neck dissection is rarely performed due to its functional impact.
• Modified Radical Neck Dissection - This neck dissection surgery is similar to radical neck dissection surgery, but the functional impact is less. Some key structures, such as the spinal cord nerves, are preserved during this surgery.
• Selective Neck Dissection - As suggested by the name, this type of neck dissection surgery involves removing only the selected neck muscles and lymph nodes, further reducing the risk of complications.
• Extended Neck Dissection - Suitable for extensive metastasis, and removal of some additional lymph nodes and nearby structures is performed.

An in-depth evaluation is necessary for neck dissection. Before initiating the neck dissection procedure, a preoperative evaluation is performed to identify the most suitable surgical approach. This usually includes the following:

• Detailed analysis of the patient’s medical history and physical evaluation.
• Imaging tests like MRI, CT scan, X-rays, or PET scan for detailed reports.
• Blood work and cardiac analysis of the patient.
• A biopsy is performed to confirm the diagnosis of the cancer.

Neck dissection surgery is performed under general anaesthesia. Since the neck is a crucial and complex structure, lymph node surgery must be performed with extra care to preserve the function of the neck muscles and nearby structures. The procedure is completed in several steps, each with its own importance. Let’s understand each step in detail.

• Anaesthesia Administration - After the preoperative evaluation and preparation measures, the patient is given general anaesthesia so that they are completely asleep during the procedure and don’t feel any pain.
• Sterilisation and Surgical Marking - The site to be operated on is appropriately cleaned and sterilised to reduce any chances of infection. Markings are then performed based on the type of neck dissection surgery to be performed.
• Skin Incisions - Incisions are then made along the marking, and the underlying tissues are gently lifted to expose the lymph nodes to the surgeon.
• Lymph Node Removal - The selected lymph nodes are carefully removed depending on the surgical procedure.
• Inspection for Hemostasis - A thorough inspection of the operative site is performed to assess for any bleeding during surgery. The blood vessels are sealed, and the site is properly cleaned to prevent infection.
• Drain Placement - During the initial healing phases after a neck dissection, drains are placed to prevent fluid buildup that could interfere with healing and recovery.
• Closure of Wounds - The incisions are closed with staples and sutures, and a sterile dressing is applied.
• Postoperative Monitoring - Once all surgical steps are successfully completed, the concerned patient is transferred to the recovery area for monitoring.
• Discharge and Rehabilitation - Once the patient stabilises, discharge is planned with clear instructions for wound care and mobility.
• Recovery and Aftercare - Routine follow-up check-ups are necessary to ensure the patient heals properly.

People with neck cancer can benefit significantly from neck dissection surgery. Some of the key benefits include:

• Effective cancer control for complex cancers like the neck and head
• Improved survival rates
• Accurate cancer staging and treatment
• Reduced the chances of recurrence of cancer cells
• Increased effectiveness of additional therapies

Like any other surgical procedure, neck dissection carries a set of risks and complications. However, when performed by an experienced surgeon, the chances of serious complications are effectively mitigated. Possible risks can include:

• Bleeding or Infection
• Swelling
• Fluid Collection
• Changes in Sensation
• Weakness or Numbness
• Scarring or Stiffness of the neck

Neck Dissection surgery is performed at Gleneagles Hospitals with the most advanced tools and technology.

Some facilities available at the hospital, which make it the best hospital in the country for head and neck malignancies, include:

• Expertise in head and neck oncology
• Personalised and evidence-based care plans
• Integrated Oncology Infrastructure for seamless treatment experience
• Holistic support and guidance on every step
• Advanced Surgical and Diagnostic Technologies

Patients are guided before surgery and monitored after the procedure. Patients receive comprehensive postoperative care and guidance as part of the rehabilitation regimen at Gleneagles Hospitals.