What is a Neck Dissection?

A neck dissection is a surgical procedure to remove lymph nodes from one or both sides of the
neck.

What are Lymph Nodes?

Lymph nodes are small glands located throughout the body. You may have noticed swollen nodes
in your neck during an infection, such as a cold. Lymph nodes filter fluid (called lymph) that
leaks from blood vessels. They contain white blood cells that trap and fight bacteria, viruses, and
other harmful substances. Lymph nodes can also trap cancer cells.

Do I Have Cancer in My Lymph Nodes?

It is usually not possible to confirm this until after surgery. The removed nodes are examined
under a microscope. Your doctor may have already checked your neck for lumps and performed
scans (CT or MRI) to assess the glands.
Swollen nodes can occur with infections, so a lump does not necessarily mean cancer has spread.
Sometimes, even if small amounts of cancer cells are present, the nodes can feel normal and
appear normal on scans. This is why the exact spread to the neck is often only confirmed after
microscopic examination.

Will I Still Be Able to Fight Infections?

Yes. The body contains thousands of lymph nodes, so your immune system remains effective
even after some are removed.

When is the Surgery Performed?

Neck dissection is often done at the same time as surgery to remove cancer from the mouth or
face. It is carried out under general anaesthetic, meaning you will be fully asleep.

What Does the Surgery Involve?

• A large incision is made in the neck to access the lymph nodes. The cut typically starts
  just under the chin, extends down toward the collarbone, and arcs upward behind the ear.
• The skin is lifted to expose the lymph nodes.
• The nodes are carefully removed, and the skin is stitched or clipped back into place.

What to Expect After Surgery

• Drains: Tubes may be placed to remove any blood that collects. These are usually
  removed after a few days.
• Discomfort: Some pain is expected, usually worst in the first few days. Painkillers will
  be provided.
• Antibiotics: Given intravenously to reduce infection risk.
• Stitches/Clips: Usually removed about a week after surgery.
• Numbness: Bruising of nerves can leave the skin of your neck feeling numb for several
  months.

Possible Complications

While complications are rare, it is important to be aware of potential issues, mainly related to
two nerves:

1. Accessory Nerve

• Runs from the top to the bottom of the neck and controls shoulder movement.
• May be bruised during surgery, causing pain or difficulty lifting your shoulder,
  making dressing more difficult.
• Rarely, the nerve may need to be cut, leading to permanent shoulder issues.

2. Facial Nerve (lower branch)

• Controls movement of the lower lip.
• May be bruised during lymph node removal, causing weakness or a crooked
  smile.
• Most cases improve over several months, but recovery may be gradual.

Will I Need Further Treatment?

The need for additional treatment depends on the microscopic examination of the lymph nodes.
Results take several weeks. If required, further treatment often involves radiotherapy to target
any remaining cancer cells.