Oncologic (Cancer) Surgeries

Neck dissection is a surgical procedure performed to remove lymph nodes and surrounding tissues in the neck when cancer has spread or there is a high risk of spread, especially in head and neck cancers. The aim is to control regional disease, improve survival, and guide further treatment such as radiotherapy or chemotherapy. The type of neck dissection depends on the extent of disease, location of the primary tumor, and involvement of vital structures. Surgeons carefully balance complete cancer removal with preservation of important nerves, muscles, and blood vessels to maintain function and appearance.

Selective Neck Dissection

Selective neck dissection involves removal of only specific groups of lymph nodes that are most likely to contain cancer, while preserving other structures.

• Only high-risk lymph node levels are removed
• Preserves major structures like spinal accessory nerve, internal jugular vein, and sternocleidomastoid muscle
• Less morbidity with better cosmetic and functional outcomes
• Commonly used in early-stage cancers or clinically negative neck

Modified Radical Neck Dissection

This is a more extensive surgery where most lymph node groups are removed, but one or more key structures are preserved to reduce complications.

• Removes lymph nodes from levels I–V
• Preserves one or more structures (nerve, vein, or muscle)
• Lower risk of shoulder dysfunction compared to radical dissection
• Used in patients with confirmed lymph node involvement

Radical Neck Dissection

Radical neck dissection is the most extensive form, involving removal of all lymph node groups along with important surrounding structures.

• Removes spinal accessory nerve, internal jugular vein, and sternocleidomastoid muscle
• Indicated in advanced or aggressive cancers with extensive spread
• Higher risk of functional and cosmetic deficits
• May require reconstructive procedures and rehabilitation