Four types of neck dissection surgery
Neck dissection or cervical lymphadenectomy is a surgical procedure to examine and remove the lymph nodes and surrounding tissue in the neck. The surgery is done for the management of cancer that has spread to the lymph nodes in the neck. Neck dissection is a major surgical procedure. It is done in a hospital using general anesthesia (the patient sleeps through the procedure). When cancer spreads from its site of origin (primary site) to other sites in the body, it is called metastasis. Metastasis of lymph nodes, which are small glands scattered throughout the body, is quite common. These lymph nodes help fight infections as well as filter and process lymph fluid from different organs. Thus, they may trap some cancer cells as well. The cancer cells that get caught in the cervical (neck) lymph nodes lead to the swelling of these nodes, which may be felt as a lump in the neck. Neck dissection may be done when:
- The person has cancer of the mouth, tongue, thyroid gland, or other areas in the head and neck regions.
- Cancer has spread to the lymph nodes.
- There is a probability of cancer spreading to other parts of the body.
There are various types or levels of neck dissections based on the structures removed during the surgery. This depends on the extent to which the tumor has spread or metastasized. The four main types of neck dissection are:
Radical neck dissection:
This is the standard procedure for neck dissection, and all other forms of neck dissections are a modification of this procedure. It involves the removal of all the tissue on the side of the neck, from the jawbone (mandible) to the collarbone (clavicle). In radical neck dissection, most of the tissues including the major blood vessels, nerves, muscles, and salivary gland present in the area are removed. Radical neck dissection aims at complete cancer removal in people with advanced cancers in the neck. The procedure, however, may cause considerable cosmetic concerns because a large amount of tissue is removed. The removal of several nerves and muscles calls for an intensive physical therapy program after the surgery.
Modified radical neck dissection:
In this modification of the radical neck dissection, lesser neck tissues are removed as compared to the radical dissection. It is the commonest type of neck dissection. In this procedure, all the lymph nodes on the side of the neck are removed. It may spare some non-lymphatic tissue, such as some nerves, muscles, or blood vessels.
Selective neck dissection:
This procedure is done when the tumor has spread to a limited extent in the neck. Selective neck dissection involves the removal of one or more lymph node groups from the neck. It aims at preserving most of the structures, such as muscles, nerves, and major blood vessels.
Extended radical neck dissection:
The fourth type of neck dissection may be done in an advanced stage of cancer is called an extended radical neck dissection. This surgery involves the removal of additional lymph node groups or non lymphatic structures (such as nerves, muscles, and blood vessels) relative to the radical neck dissection.