Neck Dissections

What is a neck dissection?

A neck dissection is a surgical procedure that involves removing lymph nodes and surrounding tissue from the neck. This operation is commonly performed by head and neck surgeons and surgical oncologists to treat or diagnose certain types of cancer. At Hills Surgical Oncology, Dr Muzib Abdul-Razak, a highly skilled head and neck surgeon in Sydney, specialises in performing neck dissections. With clinics in Wahroonga and the Hills area, Dr Abdul-Razak provides expert care for patients requiring this complex procedure.

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Why is a neck dissection performed?

There are several reasons why your doctor might recommend a neck dissection:

• To remove cancer that has spread to the lymph nodes in the neck
• To check if cancer has spread to the lymph nodes (diagnostic purpose)
• To prevent cancer from spreading to the lymph nodes in high-risk cases
• To stage cancer and determine the best treatment plan

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What are the different types of neck dissections?

There are several types of neck dissections, each varying in the extent of tissue removed:

• Radical Neck Dissection: Removes all lymph nodes on one side of the neck, along with some muscles, nerves, and blood vessels.
• Modified Radical Neck Dissection: Removes lymph nodes but preserves some structures like the sternocleidomastoid muscle, internal jugular vein, or spinal accessory nerve.
• Selective Neck Dissection: Removes only specific groups of lymph nodes, based on the likely pattern of cancer spread.
• Extended Neck Dissection: Includes additional structures beyond those removed in a radical neck dissection.

At Hills Surgical Oncology, Dr Abdul-Razak will explain which type of neck dissection is most appropriate for your specific case.

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How do I prepare for a neck dissection?

Preparing for a neck dissection involves several steps:

1. Medical evaluation: Your doctor will perform a thorough examination and may order imaging studies like CT or MRI scans.
2. Medication review: Inform your doctor about all medications and supplements you're taking. You may need to stop certain medications before surgery.
3. Fasting: You'll likely need to avoid eating or drinking for several hours before the surgery.
4. Arrange for help: Plan for someone to drive you home after the procedure and help you for the first few days of recovery.
5. Quit smoking: If you smoke, try to quit at least a few weeks before surgery to improve healing.

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What Happens during a neck dissection?

A neck dissection is typically performed under general anaesthesia, meaning you'll be asleep during the procedure. Here's what you can expect:

1. Anaesthesia: The anaesthetist will administer medication to put you to sleep.
2. Incision: Dr Abdul-Razak will make an incision in your neck. The exact location and size depend on the type of neck dissection being performed.
3. Removal of tissue: The surgeon carefully removes lymph nodes and other tissues as planned.
4. Preservation of structures: Important nerves, blood vessels, and muscles are identified and preserved when possible.
5. Checking for bleeding: The surgical site is thoroughly checked to ensure there's no bleeding.
6. Closing the incision: The incision is closed with stitches or surgical glue, and a dressing is applied.

The entire procedure usually takes about 2 to 5 hours, depending on the extent of the surgery.[Image suggestion: A step-by-step illustration of the neck dissection procedure]

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What should I expect after a neck dissection?

After your neck dissection at Hills Surgical Oncology:

1. Recovery room: You'll spend some time in a recovery room where nurses will monitor your vital signs.
2. Hospital stay: Most patients stay in the hospital for 2 to 4 days after the surgery.
3. Pain management: You may experience some discomfort, which can be managed with pain medication.
4. Drainage tubes: You might have small tubes to drain fluid from the surgical site. These are usually removed before you go home.
5. Swelling: Some swelling in the neck area is normal and usually subsides over time.
6. Numbness: You may experience numbness in parts of your neck or ear. This often improves over time but can be permanent in some cases.
7. Follow-up appointment: Dr Abdul-Razak will schedule follow-up visits to check your recovery and discuss further treatment if needed.

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What is the recovery process like after a neck dissection?

Recovery from a neck dissection varies from person to person, but generally:

1. Rest: Take it easy for the first few weeks after surgery.
2. Incision care: Keep the incision clean and dry. Dr Abdul-Razak will provide specific instructions on wound care.
3. Pain management: Take pain medication as prescribed to manage discomfort.
4. Neck exercises: You may be given specific exercises to help maintain neck mobility and prevent stiffness.
5. Gradual return to activities: Most people can return to light activities within 2 to 3 weeks, but full recovery may take 4 to 6 weeks or longer.
6. Follow-up care: Regular check-ups with Dr Abdul-Razak are important to monitor your recovery and overall health.

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Are there any risks or complications associated with neck dissection?

Like all surgical procedures, neck dissection carries some risks. However, when performed by an experienced surgeon like Dr Abdul-Razak at Hills Surgical Oncology, serious complications are rare. Potential risks include:

• Bleeding or infection at the surgical site
• Injury to nerves, which could affect shoulder movement or sensation in the neck and ear
• Chyle leak (leakage of lymphatic fluid)
• Seroma (fluid collection under the skin)
• Scarring
• Changes in appearance of the neck

Dr Abdul-Razak takes every precaution to minimise these risks and will discuss them with you in detail before the procedure.

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How will neck dissection affect my life long-term?

The long-term effects of neck dissection can vary depending on the extent of the surgery and your individual healing process:

1. Appearance: There may be some changes in the contour of your neck.
2. Sensation: Some areas of your neck or ear may have reduced sensation.
3. Shoulder function: If certain nerves are affected, you might experience some weakness in shoulder movement.
4. Lymphedema: Some patients may develop swelling in the face or neck due to disrupted lymph drainage.
5. Follow-up care: Regular check-ups will be necessary, especially if the surgery was performed for cancer treatment.

Dr Abdul-Razak and the team at Hills Surgical Oncology will provide ongoing support and guidance to help you manage any long-term effects.

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Will my appearance change after a neck dissection?

It's natural to be concerned about how you'll look after neck dissection. Here's what you can expect:

1. Incision scar: The incision is carefully placed to be as inconspicuous as possible. Over time, the scar usually fades and becomes less noticeable.
2. Neck contour: There may be some changes in the shape of your neck, particularly if muscles were removed during the surgery.
3. Swelling: Initial swelling will subside over time, but some subtle changes in neck appearance may persist.

Dr Abdul-Razak at Hills Surgical Oncology uses advanced surgical techniques to minimise changes to your appearance while effectively treating your condition.

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How long does the neck dissection surgery take?

The duration of a neck dissection can vary depending on the type of dissection and the individual patient's condition. Generally:

1. A selective neck dissection might take 2 to 3 hours.
2. A more extensive dissection, like a radical neck dissection, could take 3 to 5 hours or more.

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When can I return to work after a neck dissection?

The time it takes to return to work after a neck dissection can vary depending on your job and how you're feeling. In general:

1. Most people can return to desk jobs within 2 to 3 weeks.
2. For jobs requiring physical labour, you may need 4 to 6 weeks off or more.
3. Some patients may require longer recovery periods, especially if additional treatment like radiation therapy is needed.

Dr Abdul-Razak will provide personalised advice based on your recovery progress and the nature of your work.

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Will I need additional treatment after a neck dissection?

Whether you need additional treatment after neck dissection depends on several factors, including:

1. The reason for your neck dissection (diagnostic or therapeutic)
2. The results of the pathology report on the removed tissue
3. The type and stage of cancer (if applicable)

Additional treatments might include:

1. Radiation therapy
2. Chemotherapy
3. Immunotherapy
4. Regular follow-up appointments and scans

Dr Abdul-Razak and the team at Hills Surgical Oncology will work closely with you to develop a comprehensive treatment plan tailored to your specific needs.

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Why choose Hills Surgical Oncology for your neck dissection?

When considering a neck dissection, choosing the right surgeon is crucial. Here's why Hills Surgical Oncology, led by Dr Muzib Abdul-Razak, is an excellent choice:

1. Expertise: As a specialist head and neck surgeon and surgical oncologist in Sydney, Dr Abdul-Razak has extensive experience in performing complex neck dissections.
2. Advanced techniques: We use the latest surgical techniques to ensure the best possible outcomes for our patients.
3. Comprehensive care: From initial consultation to post-operative care and ongoing follow-up, we provide support at every step of your journey.
4. Convenient locations: With clinics in Wahroonga and the Hills area, we're easily accessible to patients across Sydney.
5. Patient-centred approach: We understand that every patient is unique, and we tailor our care to meet your individual needs.
6. Multidisciplinary team: We work closely with other specialists to ensure you receive comprehensive cancer care if needed.

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Take home message

Neck dissection is a complex but often necessary procedure in the treatment and diagnosis of head and neck cancers. At Hills Surgical Oncology, Dr Muzib Abdul-Razak and his team are committed to providing expert, compassionate care to patients requiring this surgery.

If you're in the Hills area, Norwest, Wahroonga, or anywhere in Sydney and have been recommended for a neck dissection, don't hesitate to reach out to Hills Surgical Oncology. Dr Abdul-Razak, a leading head and neck surgeon and surgical oncologist in Sydney, is here to answer your questions, address your concerns, and guide you through the process.Remember, your health is our priority. We're here to ensure you receive the best possible care throughout your treatment journey.