How is the procedure done?

Neck dissections are done under general anaesthesia through an incision that runs along a skin crease in the neck, extending vertically on the side of the neck. Incisions are usually designed to enhance the visualisation and protection of important structures in the neck, and enable the safe removal of lymph nodes that may contain cancer.

Beneath the skin, underlying fat, and a thin layer of muscle, the dissection proceeds to identify and remove the tissue containing the lymph nodes. If the procedure requires the removal of a muscle in the neck, there may be some flattening of the neck, but removal of this muscle rarely results in significant weakness.

Are there any nerves that may be damaged?

Several important nerves are found in the neck around the lymph nodes, and depending on the area of the neck to be operated, these nerves can be at risk for damage.   The primary nerves of concern are-

• The marginal nerve, a small branch of the facial nerve which controls lower lip movement
• The spinal accessory nerve which aids in shoulder mobility and raising the arm over head
• The hypoglossal nerve, which controls movement of the tongue (uncommon)
• The lingual nerve, which controls sensation on the side of the tongue (rare)
• The vagus nerve which controls movement of one vocal cord (rare)