The health of your head and neck is one of the fundamental pillars of feeling secure. Palpable masses in the neck, painless swellings, or conditions requiring follow-up after previous cancer treatment may bring “Neck Dissection Surgery” to the agenda. This operation, offered at our clinic in Istanbul with experienced Ear-Nose-Throat and Head-Neck Surgery specialists and advanced surgical technology, serves both therapeutic and preventive purposes through excision of lymph nodes in the neck and arrangement of regional tissues.

What is Neck Dissection Surgery?

Neck dissection is a procedure where lymph nodes in the neck and surrounding connective tissue are surgically removed. The main objectives are:

  • Oncological Clearance: To reduce the risk of cancer cell spread through lymphatic pathways from the head-neck region
  • Diagnostic Evaluation: To determine the stage of disease through pathological examination of removed nodes
  • Preventive Purpose: To prevent microscopic spread in high-risk situations carrying cancer risk

According to surgical level; radical, modified radical, selective or partial neck dissection types are applied. Whichever type is chosen, the basic principle is “complete clearance, preserving anatomy with a protective approach.”

Why Choose Neck Dissection?

  • Definitive Treatment: Gold standard for controlling lymphatic spread of head-neck cancers.
  • Staging and Roadmap: Pathology results guide subsequent radiotherapy or chemotherapy decisions.
  • Preventive Surgery: Prophylactic approach against microscopic spread risk even when primary tumor is treated.
  • Function Preservation: We preserve nerve, vessel, and muscle structures as much as possible with modern techniques.
  • Rapid Recovery: Healing begins within 5-7 days with minimally invasive or protective modified techniques.
  • Multidisciplinary Care: Guarantee of joint planning with oncology, radiology, and plastic reconstruction teams.

Who Are Candidates?

  • Patients with “T1-T3” tumors originating from the head-neck region
  • Individuals with primary tumor removed but lymph node focus detected
  • Patients with high-risk premalignant lesions
  • Cases previously treated but with determined recurrence or micrometastasis risk
  • Individuals aged 18-80 with general health status suitable for surgical tolerance

Note: In advanced stage (T4) or widespread disease, alternatives (chemoradiotherapy) may be evaluated considering surgical margins.

Pre-Surgery Preparation Process

1. Detailed Consultation and Imaging

  • Neck ultrasound, contrast-enhanced CT/MR for nodal mapping
  • PET-CT for systemic metastasis screening if required

2. General Health Assessment

  • Blood tests, EKG, necessary internal medicine/cardiology approvals
  • Regulation of smoking and anticoagulant use

3. Multidisciplinary Meeting

Joint surgical planning with oncologist, radiation oncologist, and plastic surgeon

4. Information & Motivation

The scope of surgery, risks, follow-up protocol, and possible reconstruction options are explained

5. Appointment Confirmation and Preparation Instructions

8-hour fasting, regular medication intake plan, and social support coordination

How is Neck Dissection Surgery Performed?

  • Anesthesia: Comfortable sleep under general anesthesia.
  • Incisions: 6-10 cm horizontal incision parallel to neck anatomical curves.
  • Nodal Excision: Levels I-V are cleaned individually according to the selected dissection type.
  • Nerve and Tissue Protection: Spinal accessory nerve, jugular vein, and carotid branches are preserved as much as possible.
  • Reconstruction (If Required): Local or free flap repairs in extensive dissections
  • Suturing & Drain: Closure with self-dissolving sutures, 1-2 drains are placed.
  • Duration: 2-4 hours; varies according to dissection level.

The Importance of Doctor Selection

Neck dissection requires a balance between oncological control and function preservation. The ideal team:

  • ENT / Head-Neck Surgery Specialist: Accredited certificate in lymph node dissection
  • Plastic Reconstructive Surgeon (Multidisciplinary): Reconstruction experience for extensive field repairs
  • Oncologist & Radiation Oncologist: Coordination for post-surgical complementary treatment plans
  • Pathology Specialist: Intraoperative rapid pathology support
  • Empathetic Communication: Team that clearly explains the process, risks, and follow-up stages, taking time for your questions

Surgery Day: What Awaits You?

1. Preparation and Anesthesia Pre-Consultation

Vital measurements, surgical team introduction, and final evaluation

2. Surgical Process

2-4 hour dissection; comfort with accompanying surgeon and anesthesia team

3. Drain and Dressing

Drain placement, fine dressing, and neck corset bandage application

4. Transfer to Ward and Observation

1-3 night monitoring, vital follow-up, pain and drain management

5. Home Care Instructions

Drain care, mild painkiller protocol, and social support guide

Recovery Process

  • 1-3 Days: Drain and dressing control; painkiller and antibiotic use
  • 3-7 Days: Drain is removed; gradual permission for neck movements
  • 2 Weeks: Sutures or tapes are removed; return to light work is possible
  • 4-6 Weeks: Neck contour settles; full return to social life
  • 3-6 Months: Additional treatment and controls according to pathology results

Frequently Asked Questions

1. Will there be scarring from neck dissection?

Since incisions are made parallel to the neck’s natural curves, prominence decreases over time.

2. Is there a risk of nerve damage?

The spinal accessory nerve is preserved with protective modified techniques; minimal risk with expert team.

3. When can I return to work?

Return to social and work life is recommended within 2 weeks for selective cases, 4 weeks for modified radical cases.

4. Will my facial movements be affected?

Dissection focused on lymph nodes does not affect facial muscles; facial expressions are preserved.

5. What is the recurrence risk?

Under surgical + pathology guidance, recurrence rates are controlled within the 10-20% range with modified techniques.