Definition
A neck dissection is a radical surgical procedure to remove the cervical lymph nodes and surrounding structures in the context of tumor diseases. The aim of the operation is to remove affected or endangered lymph nodes and thereby to narrow down the cancer. In medicine, a distinction is made between elective and therapeutic neck dissection. In elective dissection, lymph nodes that are not yet affected are resected (operated out) as a precautionary measure to prevent scattering, remove any micro-metastases and guarantee optimal diagnostics. In the more radical, therapeutic neck dissection, metastases in lymph nodes are already known and surrounding structures such as nerves, vessels and muscles are also removed.
Indications
A neck dissection is performed in the context of tumor diseases. The reason for this is that tumour cells are able to move away from their actual place of growth and thus enter the lymphatic system. Lymph nodes form a kind of intermediate station in the lymphatic system and filter conspicuous inflammatory cells or tumour cells out of the lymph so that they can accumulate within the nodes.
The tumor cells form cell groups and grow, which leads to lymph node metastasis. As the disease progresses, one lymph node after another is affected and the cells spread along the lymphatic tract. It is therefore important in the context of tumour disease to stop this process and stop the spread. Tumours that lead to the cells settling in the cervical lymph nodes are mainly cancers of the head and neck, such as cancer of the throat, pharynx, salivary glands, oral cavity cancer, thyroid cancer or cancer of the nose and sinuses. A neck dissection may also be necessary in the context of lung cancer.
Consequences
A neck dissection can vary greatly depending on the type and stage of the cancer. Depending on how radical the neck dissection is, the more likely are complications and side effects of the procedure. The final size of the operation depends mainly on whether it is an elective (preventive) or therapeutic dissection.
Depending on how much surrounding tissue and muscle has to be removed, there may be a severe loss of tissue, which may have cosmetic consequences. In addition, excessive scarring is possible, which can cause problems in the course of the procedure. The resection of muscles and nerves can cause movement restrictions, paralysis, loss of sensation and tingling.
In a therapeutic neck dissection, a large cervical vein (vena jugularis interna) is often also removed, which can lead to flow disturbances and swelling afterwards, especially in the case of bilateral resection. The removal of lymph nodes and lymph vessels can also be accompanied by swelling, in the form of lymphedema, or a weakened immune system. In addition to the specific side effects, the general risks of surgery should also be taken into account, which can also have long-term consequences.
