Neck Dissections

## Condition Overview A neck dissection removes lymph nodes in the neck that may contain cancer spread from head and neck tumours. Dr Cao performs comprehensive and selective neck dissections as part of multidisciplinary cancer care, balancing complete disease removal with preservation of function. A neck dissection is a surgical procedure to remove lymph nodes from the neck when cancer has spread (metastasised) to these nodes. It is a critical component of head and neck cancer treatment. ### Indications for neck dissection: - Thyroid cancer with lymph node metastases - Squamous cell carcinoma of the head and neck (oral cavity, oropharynx, larynx, skin) - Salivary gland cancers - Melanoma with neck node involvement - Unknown primary with cervical lymph node metastases ## Surgical Approach Dr Cao performs the full spectrum of neck dissection procedures: - **Selective neck dissection (SND)** — removal of specific lymph node groups at highest risk while preserving non-lymphatic structures (sternocleidomastoid muscle, internal jugular vein, spinal accessory nerve) - **Modified radical neck dissection (MRND)** — removal of all lymph node groups (levels I-V) with preservation of one or more non-lymphatic structures - **Radical neck dissection (RND)** — removal of all lymph node groups along with sternocleidomastoid muscle, internal jugular vein, and spinal accessory nerve (reserved for advanced disease) ## What to Expect ### Before Surgery - Comprehensive staging with CT, MRI, and/or PET-CT imaging - Fine needle aspiration biopsy of suspicious lymph nodes - Multidisciplinary team discussion (surgeon, medical oncologist, radiation oncologist, pathologist) ### During Surgery - Surgery is performed under general anaesthetic - Duration varies from 1-4 hours depending on the extent of dissection - Nerve monitoring may be used to preserve the spinal accessory nerve ### Recovery - Hospital stay of 2-5 days, depending on extent of surgery - Drain tubes are placed and typically removed within 2-3 days - Physiotherapy for shoulder function if the spinal accessory nerve is affected - Return to normal activities within 2-4 weeks