What exactly is neck dissection surgery?

Neck dissection surgery is an operation that removes one or more groups of lymph nodes from the neck, usually as part of treating head and neck cancer. It is performed by an ENT or Head and Neck Surgeon under general anaesthesia. The specific extent depends on the cancer's type, location, and stage.

What are the main types of neck dissection?

There are four main types: Radical Neck Dissection (all 5 levels plus 3 structures removed — now rarely performed), Modified Radical Neck Dissection (all 5 levels with some structures preserved), Selective Neck Dissection (only at-risk levels targeted — most common today), and Extended Neck Dissection (additional structures removed when tumour extent demands it).

How long does recovery take after neck dissection?

Most patients are discharged within 3–5 days. The drain is removed within the first week. Stitches come out at 10–14 days. Most people return to light work within 4–6 weeks. Full functional recovery takes 3–6 months. A post-treatment surveillance scan is typically performed at the 3-month mark.

What are the main complications of neck dissection?

The most common complications are: temporary shoulder weakness or stiffness if the spinal accessory nerve is affected, neck numbness from the great auricular nerve, lymphoedema (tissue swelling), and occasionally chyle leak (lymphatic fluid leakage) or wound infection. Serious complications like vascular injury are rare when performed by an experienced surgical team.

When is neck dissection surgery recommended?

Neck dissection is recommended when cancer is confirmed in the neck lymph nodes on imaging or biopsy, or when the primary tumour carries a greater than 15–20% probability of hidden nodal spread. It is also performed for post-radiation residual disease or cancer recurrence in the neck.

What is the survival rate after neck dissection surgery in India?

Survival rates depend on cancer stage and site. Stage I and II head and neck cancers treated with surgery and adjuvant therapy achieve approximately 80–90% five-year survival. Stage III/IVa disease achieves 50–70% with multimodal treatment. Well-differentiated thyroid cancer with neck dissection has greater than 95% five-year survival. HPV-positive oropharyngeal cancers have particularly favourable outcomes even with nodal disease.