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

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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 kind of treatment is used in head and neck cancer?

Are cancers of the head and neck common?

Head and neck cancers constitute only about 5 percent of all cancers. They are not common cancers, especially in comparison with cancers of the breast, lung, or colon rectal areas. However, since they are difficult to manage and the team approach is most important in treating them, we discuss the major types of head and neck cancer in some detail in this blog.

Do cancers of the head and neck metastasize to other parts of the body?

Unlike many other types of tumor, tumors in the head and neck usually remain confined to that area. They do not tend to metastasize to distant parts of the body. However, they do tend to spread to lymph nodes in the area.

What kind of treatment is used in head and neck cancer?

As is true with most other types of cancer, treatment includes all three disciplines: surgery, radiotherapy, and chemotherapy. Surgery is the treatment most often used. Usually early tumors are treated by surgery with adjoining tissue taken out. If the neck nodes are involved, a radical neck dissection may be done. Radiation therapy is used either before or after surgery. Sometimes chemotherapy is combined with immunotherapy in treating patients with head and neck cancer.

Is reconstructive surgery usually necessary for head and neck cancer?

It depends upon the kind of cancer, the extent of the tumor, and the kind of surgery which is performed. In many cases of cancer of the head and neck, reconstructive surgery is not necessary. However, where needed, skillful skin and bone grafting allows persons who have had radical surgery to return to as normal an appearance and function as possible.

Can a person develop head and neck cancer from smoking or chewing tobacco?

Cancer of the lip, tongue, mouth, and pharynx (the space behind the nose and mouth) do occur more often in people who smoke, chew tobacco, or use snuff. Snuff, particularly when used in the form of a pellet and held for long periods of time between the gum and the cheek, frequently causes irritation and may eventually produce cancer at the spot. Chewing tobacco has also been linked to the development of cancer of the mouth.

Are there any new treatments being tried for head and neck cancer?

There are several new treatments being tested, especially for large tumors of the head and neck region or tumors that have spread beyond the area. Chemotherapy, immunotherapy, a combination of the two treatments, chemotherapy used before surgery to shrink the tumor, chemotherapy and/ or radiotherapy after surgery, chemotherapy followed by radiation therapy are all being tried with some success. Radium implants are being used in the treatment of mouth cancer.

How will I know what exercises to do?

Don't do any exercises until your doctor or your physical therapist tells you to. You may need to be seen by a physical therapist, who will determine your condition and give you exercises which will help your particular case. He or she will show you how to do them and tell you how often they should be done. It is important to make sure you do these exercises regularly. If they are not done, you may find the shoulder on the operated side will fall forward and look lower than the one on the other side. And if the surgery was on both sides of the neck, you might find that both shoulders are falling forward and you will be standing and sitting in an uncomfortable, slumped over position which may cause shoulder pain.

Head and Neck Cancer (Risk Factors, Pathology, Clinical Picture, Diagnosis and Management)

Will I have trouble eating or swallowing after head and neck surgery?

You may have trouble in chewing, swallowing and speaking. You may also find your appearance has changed. Rehabilitation is a very important part of your treatment and may include plastic surgery.

Is it true that many patients with head and neck cancer get very depressed and discouraged?

Again, it depends upon the site of the cancer and the attitude of the patient. Many patients whose operation has caused facial disfigurement or a great change such as a laryngectomy naturally go through some depressed periods. However, when they find out that they can live their lives in much the same fashion as they did before with reconstructive surgery and help in learning to speak most head and neck patients find that life is still worth living. However, most people need support and help from family and friends to get through the difficult period of adjustment.

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