Our body has a tremendous defense mechanism and the lymphatic system plays a very important role in this process. It is a system which saves our body from harmful infections. They are like blood vessels and are spread in different parts of the body. It has a yellowish fluid which is known as lymph and it consists of white blood cells and serum. Lymphatic system consists of lymph nodes which act as filters for infections. These lymph nodes swell when they trap any infection so as to remove it from the lymphatic system.
When there is any cancerous tumor nearby, the lymph carries cancerous cells which get trapped inside the lymph node and start developing there. This is known as lymph node metastasis. In case of cancer in the neck and head, the lymph nodes also get affected which results in the spread of cancer in the lymphatic system. So, the best way to get rid of this problem is to get the lymph nodes removed.
What is Neck Lymph Node Removal?
Neck lymph node removal is also known as neck dissection. It is the removal of the lymph nodes and the surrounding tissues from the cancer affected area. The extent of the removal may depend upon the area affected and the purpose of the removal. The detection of the affected node is done with the help of CT, MRI, PET scanning. The removal of the node may also help in determining the presence of cancerous cells in the lymphatic system.
Types of Neck Dissection
There are three types of neck dissection and the type of dissection used will depend upon the type of cancer. Following are the types of neck dissection process.
Radical Neck Dissection
This process includes the removal of lateral neck nodes and tissues. It has been in use for many years. This process includes the removal of almost all the lymph nodes of the neck with the tissues from the collarbone to the jawbone. The cranial nerve, internal jugular vein and sub mandibular gland which is a salivary gland present in the upper neck are also removed.
Modified Radical Neck Dissection
This type is used when there is considerable spread of cancerous cells but as compared to the radical neck dissection this method has less removal of tissues. If the lymph node metastasis is present then all the lymph nodes may be removed from the neck without the removal of any nerve or vein. In this type even the muscles can also be preserved from getting removed.
Selective or Functional Neck Dissection
There are 6 lymph nodes in the neck region, hence in this type only a particular section or a group of lymph nodes will be removed instead of all the lymph nodes, muscles and veins. This type is used in three conditions: To check if all the cancerous cells are killed with the help of chemotherapy or any other radiation therapy, to find out if the cancer has spread to the lymphatic system and to remove a small malignant lymph node.
Neck Dissection Procedure
The neck dissection procedure may take 2 to 4 hours depending upon the type of dissection. It is done under general anesthesia. An incision is made along the skin crease which is vertical in case of radical and modified radical neck dissection. The affected lymph node is identified and then removed. No muscle other than sternocleidomastoid muscle is removed. The incision is closed either with the help of nylon sutures or skin staples. The surgery leaves very few scars which get lightened with time. The staples and sutures are removed after 6 to 10 days.
Neck Dissection Side Effects
There are many side effects of neck dissection but they are usually very minor. Following are some of the risks and complications of this method.
- There may be discomfort and weakness in the neck muscles because of the removal. This can be recovered with the help of physical therapy recommended by the doctor.
- Weakness in the lower lip may be observed which may disappear with recovery.
- Numbness in the neck skin may be observed which may take even as long as a year to recover.
- The nerves may get trapped in the scar and form a small nodule which can be sensitive to touch. This usually happens after several months or year.
- Injury to the blood vessels, i.e., arteries and veins may result in bleeding. It is a very common side effect but if the condition becomes worse, the patient may be taken back to the operation theater to get it corrected.
- Like bleeding, there may be lymphatic leakage also due to the injury caused to the lymphatic system. In case of excess leakage it may be operated to repair.
- Infection is very common in surgeries. Hence, extra care should be taken to avoid infections in the wound.
You need to be on a soft and liquid diet after the operation. Keep your wounds clean and follow all the instructions of your doctor. After three weeks or so, you can massage your wounds with the help of vitamin E or aloe oil which will lighten your scars. But consult your doctor before using it. Hope this HealthHearty article was informative and helpful. Take care!