Neck Dissection (Functional, Modified or Radical Neck Dessection)

The following are the possible complications and risks associated with these procedures. In addition to those listed, there may be some unforeseen complications with any operative procedure.

1. Weakness of the Lip, Tongue, Shoulder, Diaphragm or Vocal Cord: The nerves going to these structures have their major pathways in the neck. This places the nerves at risk with any dissection in this area. On occasion, one or more of these nerves requires removal with the tumor in the neck. In other cases, the paralysis may be temporary and require no additional therapy.
2. Infection: Infection can occur with any surgical procedure. The risk of infection is increased when a neck dissection is combined with some procedure, which allows entry into the upper digestive tract. In addition, a severe infection of the neck may result in the loss of a portion of the skin of the neck. Although it is rare, such an occurrence is increased when the neck has received previous radiation. Management of infection generally requires prolonged hospitalization, and in some cases, surgical intervention.
3. Bleeding: Significant postoperative bleeding from the neck is an extremely rare occurrence. When it does occur, it requires immediate surgical management.
4. Chylous Leak: The major lymph vessels terminate in the lower part of the neck. On occasion, such vessels are included in the neck dissection and may result in a collection of lymph fluid under­neath the skin of the neck. Such a collection may require prompt evacuation and external compression.
5. Carotid Artery Injury: A significant carotid artery injury is a rare occurrence in the routine neck dissection. In some cases, removal of the outer lining of the artery is required during the removal of a tumor. A tear in the artery is usually corrected by a simple repair. On extremely rare occasions, ligation of the artery is required. This is associated with death in 20% of the cases and stroke in approximately 25% of the cases. Fortunately, this is an extremely rare occurrence. Manipulation of the carotid artery affected with severe arteriosclerosis (hardening) can result in either a temporary or permanent stroke. This, too, is an extremely rare event.
6. Scar/Cosmetic Defect: Attempts are made to place incisions in natural skin creases. Some depression in the skin overlying the surgical site may occur secondary to removal of tissue.
7. General Anesthesia Complications: There are risks involved with any anesthesia, including cardiac arrhythmia and breathing problems. You may discuss these with the anesthesiologist if desired.
   
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