The human body’s complex lymphatic system contains 600 lymph nodes, of which 200 are located in the head and neck. Lymph nodes are a vital part of the immune system and are responsible for filtering and trapping infected material. The propensity of head and neck cancers to spread to the nearby lymph nodes makes them especially complex. When this occurs, the lymph nodes are removed using a procedure known as a neck dissection.
Why is a Neck Dissection Necessary?
Similar to the vascular system, the lymphatic system is a transportation mechanism. Instead of blood, the lymphatic system carries a fluid called lymph throughout the body. Lymph contains white blood cells, which the body uses to fight infections. When a cancer of the head or neck affects the lymph nodes, the cancer can easily spread to distant organs through the lymphatic system. This is referred to as lymph node metastasis.
Removing the affected lymph nodes and the surrounding tissue serves two important purposes. First, removing the cancerous nodes can prevent the cancer from metastasizing to other organs. Once removed, the lymph nodes can also be examined to determine the severity and extent of the cancer and identify the most appropriate treatment regimen.
How a Neck Dissection is Performed
Several different neck dissection techniques are available. Since lymph nodes are arranged in groups or zones, the surgeon may decide to remove one or more groups of nodes in addition to the ones that are enlarged. Depending on the extent to which the cancer has spread, the surrounding structures of the accessory nerve, internal jugular vein, and sternocleidomastoid muscle may also have to be removed. Your surgeon will determine the most appropriate technique based on the severity of your cancer, the location of the affected lymph nodes, and whether any surrounding structures need to be removed.
Types of Neck Dissections
- Radical Neck Dissection
A radical neck dissection is used when the cancer has spread extensively. This involves removing all of the lymph nodes from zones I through V along with the surrounding accessory nerve, sternocleidomastoid muscle, and internal jugular vein.
- Modified Radical Neck Dissection
A modified radical neck dissection leaves one or more of the surrounding structures intact, which results in the removal of less tissue.
- Selective Neck Dissection
If the cancer is diagnosed early, a selective neck dissection may be an option. Instead of removing nodes from all five zones, only selected nodes are removed, which preserves the most amount of tissue.
A neck dissection is a valuable tool in helping individuals with head or neck cancers become cancer-free. Regardless of the technique used, the goal of a neck dissection is to remove all of the cancerous nodes while preserving as much of your healthy tissue as possible. Before your surgery, the doctor will explain the procedure to you in detail, answer any questions that you may have, and tell you what you should expect during the recovery process.