When an ultrasound-guided FNA has confirmed that a lymph node in the lateral neck area (outside the left or right carotid artery) contains cancer, a lateral neck dissection is necessary.
Lymph nodes that are outside the area bounded by the carotid arteries cannot be removed through the incision used for a thyroidectomy. The incision used for a lateral neck dissection usually extends from the end of the thyroidectomy incision up to just behind the earlobe.
A lateral neck dissection removes all of the lymph nodes along your jugular vein from your jaw bone down to your collar bone. It is referred to as a "modified" or "functional" neck dissection because we remove the lymph nodes without removing any vital nerves, blood vessels, or muscles.
Occasionally, the lymph nodes are stuck to one or more of the following structures, requiring their removal:
The operation typically lasts 2-4 hours (in addition to the time required for a thyroidectomy and/or central neck dissection if being done at the same surgery). One or two thin plastic tubes (drains) are placed at the time of the surgery and will come out the skin below your collar bone. A cosmetic skin closure is performed after the tube is removed. It is normal for there to be some numbness of the skin on the jaw, neck, and ear. Most of the time this numbness is temporary, but it can last several months.
The main complications of a lateral neck dissection involve the numerous nerves which run through the neck. The risk of injury to each nerve is about 1%. The nerves at risk are as follows:
In addition to injury to nerves, there is a small risk (1% or less) of significant bleeding, infection, leakage of lymph fluid, or shoulder pain. Fluid collection in the neck rarely occurs after the drain is removed.
This information is provided by the Department of Surgery at the University of Colorado School of Medicine. It is not intended to replace the medical advice of your doctor or healthcare provider. Please consult your healthcare provider for advice about a specific medical condition.