Here at UC Irvine’s highly acclaimed Department of Head and Neck Surgery, we pride ourselves on offering Orange County the best possible medical care available. We offer comprehensive treatment for patients with cancer of the head and neck. With some of Southern California’s top Otolaryngologists on staff, each with their own advanced understanding and knowledge of several distinct disciplines, along with a state-of-the-art facility in the “head” of Orange County, we offer our patients nothing less than the best when it comes to diagnosis, treatment, management, and care.
One of the most complex aspects of head and neck cancer is that it can often spread to the surrounding lymph nodes in the neck. Of the 600 lymph nodes in the human body, there are 200 nodes present in the head and neck region. These lymph nodes are part of our body’s unique immune system as it functions to filter and trap infected material. If cancer of the head and neck region has spread to the surrounding lymph nodes, they must be removed in a surgical procedure called Neck Dissection.
In its early stages, cancer grows in a specific area. As it continues to grow, some forms of cancer can travel to other parts of the body via the lymphatic system. The lymphatic system is similar to the vascular system of blood vessels, but instead of transporting blood, the lymphatic system transports lymph, the liquid which carries our immune systems white blood cells to fight infection. When cancer spreads through the lymphatic system is it called lymph node metastasis, a troublesome sign as the cancer may spread to other lymph nodes and even distant organs via the lymphatic system.
Several types of head and neck cancer can spread through the lymphatic system to nearby lymph nodes. Whenever this situation arises, neck dissection is often performed to not only remove the cancer, but also so that the indicated lymph nodes can be examined microscopically by a pathologist who can determine the extent and severity of the spread of the cancer. Removing these indicated lymph nodes, as well as the tissue surrounding the lymph nodes, can prevent the cancer from spreading to distant organs.
Once our highly experienced, Board Certified Head and Neck Surgeons establish that cancer has or may spread to the lymph nodes, a treatment plan that may include neck dissection will be determined. During the neck dissection procedure here at UC-Irvine, your head and neck surgeon will examine the larynx and surrounding tissues. Because lymph nodes are arranged in groups, a group of surrounding lymph nodes that the cancer might spread to may be removed in addition to any nodes that are enlarged.
There are multiple different types of neck dissection that can be performed based on the severity of the cancer which has spread. The different types of neck dissection are classified based on the where nodes are being removed from (zones I-V) and whether or not the important surrounding structures are removed. The three structures we are referring to are: the internal jugular vein, the accessory nerve (cranial nerve XI), and the sternocleidomastoid muscle. Our highly trained head and neck surgeons will only remove as much tissue as is necessary to remove the cancer. Depending on the severity and extent of your cancer, an individualized patient specific neck dissection will be performed.
Radical Dissection: This form of neck dissection is performed if the cancer has spread widely. All of the nodes from zones I-V will be removed, as will the surrounding internal jugular vein, accessory nerve, and sternocleidomastoid muscle.
Modified Radical Dissection: If one or more of the 3 main surrounding internal jugular vein, accessory nerve, and sternocleidomastoid muscle is left intact, the procedure is referred to as a modified radical dissection, which removes less tissue.
Selective Neck Dissection: In this type of neck dissection, even less tissue is removed. This usually occurs when cancer is discovered early. The surgeon selects nodes to remove without removing nodes from all five zones.
The goal of neck dissection is always to remove all of the cancer while preserving as much healthy tissue as possible. The procedure will be discussed and explained in detail with you. Here at UC-Irvine, we guarantee our highest level of care for you from diagnosis all the way through a complete recovery. We are here to help get you back to living your life, cancer free, the way it should be.