Auckland DHB ENT - Otorhinolaryngology (ORL)
A neck dissection is an operation designed to remove groups of lymph nodes from the neck for treatment of cancer that has actually or potentially spread from a primary site in the head and neck to the regional nodes.
There are two types of neck dissection and several subtypes within these two groups:
Selective Neck Dissection
Level I-III (Supraomohyoid)
Level I-IV (Extended supraomohyoid)
Level II-IV (Lateral)
Level II-V (Posterolateral)
Level VI (Central)
Level VII (Superior mediastinal)
Comprehensive Neck Dissection
Neck dissections are either performed in isolation or in association with resection of the primary lesion and the approach may vary depending on the site of the primary. Incisions (cuts) are usually made from the region of the mastoid tip (behind the ear) passing in a curved fashion below the jaw forward into the submental (beneath the chin) region. There is frequently another incision that passes from the mid point of the upper incision down towards the clavicle (collar bone). Flaps are raised in the superficial muscle layer (platysma) of the neck. The lymph nodes and other structures are then removed with preservation of vital nerves and blood vessels. At the end of the procedure the wound is closed over suction drains.