What is a radical neck dissection? when is it done?

What is a radical neck dissection? The surgeon removes a block of tissue from the collarbone to the jaw and from the front to the back of the neck. The large muscle on the side of the neck that is used for rotating, flexing or extending the neck is also taken out, along with the major vein on the side of the neck. Sometimes, a less drastic operation, called a supraomohyoid neck dissection is done. This takes out only the lymph nodes, the tissue surrounding the nodes and a muscle at the front of the neck. Another technique, called a functional neck dissection, saves the muscles of the neck, taking out only the lymph nodes and tissues surrounding them.
What kind of incision is made with a radical neck dissection? The incision depends upon what the surgery is for. It can run from below the ear to the collarbone. Everything in the front of the neck on one side or on both sides may be removed. This may include the lymph nodes, blood vessels, nerves, and the salivary gland under the jawbone.

What is a stoma and how does it work

What is a stoma?

A stoma is an opening or hole made in the skin for the end of the small or large intestine in cases where it must be brought through the abdominal wall. The end of the intestine is fastened at the skin level so that it cannot slip back. The diameter of the opening may vary from 1/2 inch to 3 inches or more.

What is the name of the operation used to create a stoma?

This surgery is an ostomy. Whether permanent or temporary, it takes the name of the area where it is performed. If in the colon, it is called a colostomy. Following colostomy,bowel movements are received in a pouch placed over the stoma.

A stoma sounds uncomfortable. Is it?

A well cared for, healthy stoma is comfortable and painless and does not interfere with physical activity. However, much of the success with which a patient is able to handle the stoma is determined by the way in which the surgery is carried out, as well as the attitude of the patient.

How can I be sure that mine will be a stoma that is easily manageable?

That is a hard question but a very important one. First of all, make certain that your surgeon is someone who specializes in this particular type of operation. Some surgeons undertake these operations without the benefit of repeated experience, and though they provide a stoma which is surgically correct, the stoma may not be functional from the patient's point of view. So, be warned. Ask the doctor how often he has performed this surgery. Ask if he examines the ostomy each time the patient visits him. Ask him what kind of long term routine supervision he is prepared to give you or can suggest for you. You might even ask him if he has a patient who has had this operation who would be willing to talk with you. Be absolutely certain that the doctor has located a suitable site for the stoma before you are on the operating table. He will undoubtedly ask you to stand, sit,and lie down as he notes your body so he can determine the best site for stoma placement.

How does a stoma work?

Stomas situated in scars, in the navel, or where you wear your belt (particularly if you are a man) can be quite unmanageable. Proximity to bony prominences, or the waistline, or interference by rolls of fat all can interfere with the use of ostomy appliances. These problems cause soiling and often make it difficult for the patient to make a good recovery. So be sure the doctor discusses with you the actual location ofthe opening. The type of ostomy you have determines where the stoma will be to some extent and the nature of the discharge you will have. Ask the doctor to show you on a diagram what portion of your colon he will remove and where the stoma will be.


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