Lymph nodes are also called lymph glands. Surgery to remove lymph nodes in the neck is called a neck dissection.
You might need to have lymph nodes removed from just one side of your neck or you might need to have them removed from both sides. Removing the lymph nodes reduces the chance of the cancer spreading or coming back.
There are different types of neck dissection, including:
- partial or selective neck dissection
- modified radical neck dissection and
- radical neck dissection
Partial or selective neck dissection
If you have a partial or selective neck dissection, your surgeon removes some of the lymph nodes in one side of your neck.
Modified radical neck dissection
There are 3 types of modified radical neck dissection.
With one type your surgeon removes most of the lymph nodes between your jawbone and collarbone on one side of your neck.
With the other 2 types your surgeon also needs to remove one or more of the following structures:
- a muscle at the side of your neck called the sternocleidomastoid
- a nerve called the accessory nerve
- a vein called the internal jugular vein
Radical neck dissection
If you have a radical neck dissection, your surgeon removes most of the nodes on one side of your neck. They also remove all of the muscle on that side of your neck (the sternocleidomastoid muscle), the accessory nerve and the internal jugular vein.
Possible side effects after removing the lymph nodes
The side effects depend on which structures have been removed or disturbed during surgery.
Shoulder stiffness and arm weakness
The accessory nerve controls shoulder movement, so if you have this removed, your shoulder will be stiffer and more difficult to move. If you have a partial or modified neck dissection, the weakness in your arm usually lasts only a few months. But if you have your accessory nerve removed, the damage is permanent.
Your doctor will refer you to a physiotherapist, who will show you some exercises to help improve the movement in your neck and shoulder. It is important that you do these exercises regularly.
If you are still having problems with pain and movement a year after surgery, your doctor may look into whether a further operation to reconstruct some of the muscles might help. But this isn't suitable for everyone.
You may also have some pain. Taking painkillers can help. Physiotherapy exercises can also reduce pain. Your doctor can refer you to a pain clinic if the pain continues or is not controlled with painkillers.
A thinner, shrunken and stiff neck
Your neck will look thinner and shrunken if you have had the sternocleidomastoid muscle removed.
Your neck might be stiff after the operation and you might need physiotherapy.
After surgery to remove lymph nodes from your neck, you are at risk of getting lymphoedema in your neck or face. Lymphoedema means a build up of lymph fluid that causes swelling. It can develop because surgery interferes with the normal flow of lymph in the lymphatics.
Lymphoedema in the head or neck can also cause symptoms inside your mouth and throat. This may include swelling of your tongue and other parts of your mouth.
Tell your doctor if you have:
- any swelling or a feeling of fullness or pressure
- find it difficult to swallow
- have changes in your voice
Chyle is tissue fluid (lymph) that contains fat after it has been absorbed from the small bowel (intestine). It gets transported through the lymphatic channels to the bloodstream.
Sometimes one of these channels, called the thoracic duct, leaks after the operation. When this happens, lymph fluid or chyle can collect under the skin.
You may need to stay longer in hospital and go back to the operating theatre to repair the leak.
Sometimes the tubes of the drain that the surgeon puts in during surgery can become blocked. This can cause blood to collect under the skin and form a clot (haematoma). If this happens, you might need to go back to the operating theatre to have the clot removed and the drain replaced.
Other possible effects
You might have other effects due to damage to some of the nerves that supply the head and neck area.
- numbness of the skin and the ear on the same side as the operation
- loss of movement in the lower lip
- loss of feeling or movement on one side of the tongue