NECK, RADICAL DISSECTION OF

General Information

DEFINITION--Removal of cancerous growths in the tissues in the neck.

BODY PARTS INVOLVED--Neck muscles; lymph glands; windpipe.

REASONS FOR SURGERY--Cancer in the oral cavity or neck, which will spread to other parts of the body if not removed.

SURGICAL RISK INCREASES WITH

• Adults over 60.
• Obesity; smoking.
• Poor nutrition.
• Recent or chronic illness, especially respiratory illness.
• Alcoholism.
• Use of drugs such as: antihypertensives; muscle relaxants; tranquilizers; sleep inducers; insulin; sedatives; beta-adrenergic blockers; or cortisone.
• Use of mind-altering drugs, including: narcotics; psychedelics; hallucinogens; marijuana; sedatives; hypnotics; or cocaine.

What To Expect

WHO OPERATES--Ear, nose and throat specialist or general surgeon.

WHERE PERFORMED--Hospital.

DIAGNOSTIC TESTS

• Before surgery: Blood and urine studies; x-rays of chest; ECG (See Glossary).
• After surgery: Blood studies.

ANESTHESIA--General anesthesia by injection and inhalation with an airway tube placed in the windpipe.

DESCRIPTION OF OPERATION

• An incision shaped like an "H" is made in the neck. Skin flaps are separated from the underlying tissue.
• The lymph glands, muscles, jugular vein and connective tissue are cut free and removed.
• Sometimes, a tracheostomy (see in Surgery section) is performed.
• Tubes are left in the surgical area to drain secretions.
• The connective tissue is closed, and the skin is closed with sutures or clips, which usually can be removed about 1 week after surgery.

POSSIBLE COMPLICATIONS

• Excessive bleeding.
• Surgical-wound infection.
• Restricted breathing.
• Inadvertent injury to the large blood vessels and nerves in the neck, tip of the lung, thoracic duct or laryngeal nerve.

AVERAGE HOSPITAL STAY--13 to 15 days.

PROBABLE OUTCOME--Expect complete healing. Removing tissue in the neck may cause some unavoidable disfigurement. However, some cancers can be cured completely with this surgery. Allow about 4 weeks for recovery from surgery.

Postoperative Care

† Move and elevate legs often while resting in bed to decrease the likelihood of deep--vein blood clots.

MEDICATION---

Your doctor may prescribe:

• Pain relievers. Don't take prescription pain medication longer than 4 to 7 days. Use only as much as you need. > Stool softeners to prevent constipation. > Antibiotics to fight infection.

ACTIVITY

• Resuming daily activities, including work, as soon as you are able can help the healing process.
• Avoid vigorous exercise for 6 weeks after surgery.
• Resume driving 5 weeks after returning home.

DIET--Clear liquid diet until the gastrointestinal tract begins to function again. Then eat a well--balanced diet to promote healing.

Call Your Doctor If

† Pain, swelling, redness, drainage or bleeding increases in the surgical area.

• You develop signs of infection: headache, muscle aches, dizziness or a general ill feeling and fever.
• You experience new symptoms such as: nausea; vomiting; constipation; abdominal swelling; hoarseness; or difficulty with breathing.