Head & Neck

This is a surgical procedure aimed at removing groups of lymph nodes from the neck to treat cancer that has either spread or has the potential to spread from its primary site in the head and neck. Neck dissections are performed when either one of the situations mentioned hereon, presents itself. Therapeutic neck dissection is performed when neck lymph nodes are clinically or radiologically confirmed to be involved with cancer while elective neck dissection is conducted when there is a high likelihood that lymph nodes may be involved with cancer, even though no clinical or radiological signs are present.  Neck dissections are either performed in isolation or in association with resection of the primary lesion. The approach may vary depending on the site of the primary.

There are two types of neck dissection: Selective and Radical/Modified Radical. Selective neck dissection involves the removal of only certain groups of lymph nodes in the neck, while preserving others that are not likely to be involved in the cancer spread process (metastasis). There are different levels of selective neck dissection (e.g. levels I-V), depending on which lymph node groups are removed. Its main advantage is that it preserves important structures such as nerves and blood vessels, reducing potential complications compared to more extensive dissections.

On the other hand, comprehensive neck dissection involves the removal of all lymph nodes and surrounding tissues in a specific region of the neck. It is performed when there is a high risk of cancer spread to multiple lymph node groups or when lymph nodes are already involved in the metastasis. Also, it involves the removal of lymph nodes from levels I-V (or sometimes more), including potential structures like the sternocleidomastoid muscle, internal jugular vein, and spinal accessory nerve.