Neck Dissection
What is Neck Dissection?
Neck dissection is a surgical procedure to remove lymph nodes and sometimes surrounding structures in the neck, typically to treat or stage cancers that spread to the cervical lymph nodes, such as HNSCC, thyroid cancer, or metastatic melanoma (as related to your previous query). It helps control cancer spread and guide further treatment. In India, neck dissections are performed in head and neck surgery or surgical oncology departments at hospitals like Apollo, Fortis, Medanta, Tata Memorial, and AIIMS, often at affordable costs. Understanding the procedure, costs, recovery, risks, and FAQs is essential for patients.
Why do you need Neck Dissection?
Neck dissection is indicated for:
- Cancer:
- Head and neck squamous cell carcinoma (HNSCC, 90% of head/neck cancers; common in India due to tobacco use, 20–30 per 100,000).
- Thyroid cancer (e.g., papillary, 1–2 per 100,000; often spreads to neck nodes).
- Metastatic melanoma (as you asked earlier; 10–20% of melanomas spread to lymph nodes).
- Salivary gland cancers or oral cavity cancers (e.g., tongue, 30–40% have nodal spread at diagnosis).
- Staging:
- Determines extent of cancer spread (N staging); guides radiation/chemotherapy.
- Associated treatments:
- Often combined with primary tumor resection (e.g., glossectomy for tongue cancer).
- Followed by adjuvant therapy: Radiation or chemotherapy for high-risk cases.
- Timing:
- Performed in adults (average age 50–70 years for HNSCC); urgency depends on cancer stage.
The procedure aims to remove cancerous lymph nodes, prevent further spread, and improve survival, while preserving function and appearance as much as possible, often using selective or modified techniques to reduce morbidity.
Why Do Neck Dissection Costs Vary in India?
Costs range from ₹80,000 to ₹2.5 lakh :
- Procedure Type: SND (₹80,000–₹1.2 lakh); MRND (₹1.2–2 lakh); with reconstruction (₹1.5–2.5 lakh).
- Hospital/Location: Higher in metro cities (Apollo, Fortis: ₹1.2–2.5 lakh); lower in government hospitals (Tata Memorial, AIIMS: ₹30,000–₹80,000, often subsidized under Ayushman Bharat).
- Surgeon’s Expertise: Experienced head and neck surgeons charge more.
- Additional Costs: Anesthesia (₹10,000–₹20,000), hospital stay (₹5,000–₹15,000/day), pathology (₹5,000–₹10,000), medications (₹5,000–₹10,000).
- Insurance: Often covered (medical necessity); confirm with your provider.
Neck Dissection Procedure
- Before Surgery Evaluation:
- Assessment:
- Imaging: CT/PET scan to assess lymph node involvement and metastasis.
- Fine needle aspiration (FNA): Confirms cancer in lymph nodes.
- Blood tests: Blood sugar, clotting profile; thyroid function (if thyroid cancer).
- Preparation: Stop blood thinners (e.g., aspirin) 5–7 days prior if safe; assess vocal cord function (laryngoscopy).
- Consent: Risks, including nerve injury, are explained.
- Assessment:
- Surgical Technique:
- Neck Dissection:
- Performed under general anesthesia, lasting 2–4 hours.
- Types:
- Radical neck dissection (RND): Removes all lymph nodes (levels I–V), sternocleidomastoid muscle, internal jugular vein, and spinal accessory nerve; rarely used today due to morbidity.
- Modified radical neck dissection (MRND): Removes lymph nodes (levels I–V) but spares non-lymphatic structures (e.g., nerve, muscle); most common for HNSCC.
- Selective neck dissection (SND): Removes specific lymph node levels (e.g., levels II–IV for oral cancer); for early-stage or prophylactic cases.
- Extended neck dissection: Includes additional structures (e.g., skin, carotid artery) if tumor invades.
- Process:
- Incision: Horizontal (along neck crease, 10–15 cm) or hockey-stick incision for better access.
- Lymph nodes removed: Levels I–V (I: submental/submandibular; II–IV: jugular chain; V: posterior triangle).
- Preservation: Spinal accessory nerve (controls shoulder), internal jugular vein, and sternocleidomastoid spared in MRND/SND unless involved.
- Reconstruction (if needed): Skin grafts or flaps (as you asked earlier) for large defects.
- Closure: Sutures in layers; drains placed to prevent fluid buildup.
- Intraoperative Tools:
- Nerve monitor: Protects spinal accessory nerve (avoids shoulder dysfunction).
- Harmonic scalpel: Controls bleeding.
- Frozen section: Confirms margins or node involvement intra-op.
- Neck Dissection:
- After Surgery:
- Hospital stay: 2–5 days.
- Care: Shoulder physiotherapy to prevent stiffness; drains removed in 3–5 days; monitor for swelling.
- Pain management: Moderate pain for 3–5 days; managed with painkillers (e.g., paracetamol).
- Instructions: Avoid heavy lifting for 4–6 weeks; radiation (if needed) starts 4–6 weeks post-op.
Recovery After Neck Dissection
- Hospital Stay: 2–5 days.
- Post-Surgery Care:
- Pain/Swelling: Moderate pain for 3–5 days; swelling resolves in 2–3 weeks.
- Activity: Avoid strenuous activity for 4–6 weeks; light activities in 1–2 weeks.
- Drains/Incision: Drains removed in 3–5 days; sutures removed in 7–10 days; scar fades in 6–12 months.
- Shoulder function: Physiotherapy to regain strength; full recovery in 4–6 weeks if nerve spared.
- Adjuvant therapy: Radiation or chemotherapy starts 4–6 weeks post-op if needed.
- Follow-Up:
- Visits at 1 week (drain removal), 1 month, and every 3 months for 2 years (recurrence risk).
- Imaging: CT/PET at 3–6 months to monitor for recurrence.
Most resume normal activities in 3–4 weeks; full recovery takes 2–3 months. Success rate: 5-year survival for HNSCC with neck dissection is 50–70% (stage I–II); 30–50% (stage III–IV) with adjuvant therapy.
Risks and Complications
- Surgical Risks:
- Bleeding (2–5%): Hematoma in neck; may need drainage.
- Infection (2–5%): At incision site; treated with antibiotics.
- Anesthesia risks (<1%): Reaction to anesthesia; rare in healthy patients.
- Post-Surgery:
- Shoulder dysfunction (10–20%): If spinal accessory nerve injured; causes weakness (winging of scapula); managed with physiotherapy.
- Chyle leak (1–3%): Lymphatic fluid leak (if thoracic duct injured); may need surgical repair.
- Nerve injury (2–5%): Marginal mandibular nerve (lip weakness) or hypoglossal nerve (tongue movement); often temporary.
- Seroma (3–5%): Fluid collection; may need aspiration.
- Long-Term:
- Recurrence (20–40%): Cancer return in neck; needs regular imaging.
- Lymphedema (5–10%): Neck or facial swelling; managed with manual drainage.
Report fever, severe swelling, shoulder weakness, or difficulty swallowing promptly.
Frequently Asked Questions (FAQs)
What causes the need for neck dissection?
Cancer spread to cervical lymph nodes (HNSCC, thyroid cancer, melanoma); staging or treatment purposes.
Can I avoid neck dissection?
Yes, if no nodal spread: Sentinel lymph node biopsy (as in melanoma excision) or radiation; surgery needed for confirmed metastases.
Is neck dissection painful?
Moderate pain for 3–5 days, managed with medication; resolves in 2–3 weeks.
How soon can I resume normal activities?
Light activities: 1–2 weeks; full recovery: 2–3 months; avoid strenuous activity for 4–6 weeks.
Is neck dissection covered by insurance in India?
Often covered (medical necessity); confirm with your provider; Ayushman Bharat often subsidizes.
Signs of complications?
Fever, severe swelling, shoulder weakness, or difficulty swallowing.
Will I have full shoulder movement after surgery?
Yes, if nerve spared: 80–90% regain normal function with physiotherapy; some weakness if nerve sacrificed.
Lifestyle changes post-surgery?
Shoulder exercises, avoid neck strain, attend follow-ups, and monitor for recurrence.
Conclusion
Neck dissection is a critical procedure for managing head and neck cancers, with good outcomes when combined with adjuvant therapy. India’s top hospitals (Apollo, Fortis, Tata Memorial) provide affordable care, often covered by insurance. Understanding the procedure, costs, recovery, risks, and FAQs helps patients approach surgery confidently. Consult a head and neck surgeon for personalized guidance.
Looking for Best Hospitals for Neck Dissection
Note: we are not promoting any hospitals
we are not promoting any hospitals we sourced all the details from google and hospitals website, please verify and start with your surgery here we go the list includes government, budget and superspeciality hospitals accreditation bodies are the National Accreditation Board for Hospitals and Healthcare Providers (NABH) and the Joint Commission International (JCI)
- click on your city and schedule your surgery now done in good hands.
| City | Minimum Price (₹) | Maximum Price (₹) |
|---|---|---|
Agra |
2,00,000 |
5,50,000 |
Ahmedabad |
2,50,000 |
6,00,000 |
Ajmer |
2,00,000 |
5,50,000 |
Aligarh |
2,00,000 |
5,50,000 |
Allahabad |
2,00,000 |
5,50,000 |
Amritsar |
2,25,000 |
5,75,000 |
Aurangabad |
2,25,000 |
5,75,000 |
Bangalore |
2,50,000 |
6,00,000 |
Bareilly |
2,00,000 |
5,50,000 |
Belgaum |
2,25,000 |
5,75,000 |
Bhopal |
2,25,000 |
5,75,000 |
Bhubaneswar |
2,25,000 |
5,75,000 |
Bikaner |
2,00,000 |
5,50,000 |
Chandigarh |
2,50,000 |
6,00,000 |
Chennai |
2,50,000 |
6,00,000 |
Coimbatore |
2,50,000 |
6,00,000 |
Dehradun |
2,25,000 |
5,75,000 |
Delhi |
2,50,000 |
6,00,000 |
Dhanbad |
2,00,000 |
5,50,000 |
Durgapur |
2,00,000 |
5,50,000 |
Faridabad |
2,50,000 |
6,00,000 |
Ghaziabad |
2,50,000 |
6,00,000 |
Gorakhpur |
2,00,000 |
5,50,000 |
Guntur |
2,25,000 |
5,75,000 |
Gurgaon |
2,50,000 |
6,00,000 |
Guwahati |
2,25,000 |
5,75,000 |
Gwalior |
2,00,000 |
5,50,000 |
Hyderabad |
2,50,000 |
6,00,000 |
Indore |
2,25,000 |
5,75,000 |
Jabalpur |
2,00,000 |
5,50,000 |
Jaipur |
2,50,000 |
6,00,000 |
Jalandhar |
2,25,000 |
5,75,000 |
Jamshedpur |
2,25,000 |
5,75,000 |
Jodhpur |
2,00,000 |
5,50,000 |
Kanpur |
2,00,000 |
5,50,000 |
Kochi |
2,50,000 |
6,00,000 |
Kolkata |
2,50,000 |
6,00,000 |
Kollam |
2,25,000 |
5,75,000 |
Lucknow |
2,25,000 |
5,75,000 |
Ludhiana |
2,50,000 |
6,00,000 |
Madurai |
2,25,000 |
5,75,000 |
Mangalore |
2,25,000 |
5,75,000 |
Meerut |
2,00,000 |
5,50,000 |
Moradabad |
2,00,000 |
5,50,000 |
Mumbai |
2,50,000 |
6,00,000 |
Mysore |
2,50,000 |
6,00,000 |
Nagpur |
2,25,000 |
5,75,000 |
Nashik |
2,25,000 |
5,75,000 |
Navi Mumbai |
2,50,000 |
6,00,000 |
Noida |
2,50,000 |
6,00,000 |
Patna |
2,00,000 |
5,50,000 |
Pune |
2,50,000 |
6,00,000 |
Raipur |
2,25,000 |
5,75,000 |
Rajkot |
2,25,000 |
5,75,000 |
Ranchi |
2,00,000 |
5,50,000 |
Surat |
2,50,000 |
6,00,000 |
Thane |
2,50,000 |
6,00,000 |
Vadodara |
2,25,000 |
5,75,000 |
Varanasi |
2,00,000 |
5,50,000 |
Visakhapatnam |
2,25,000 |
5,75,000 |
Disclaimer
This information is sourced from open platforms and is for general awareness only. Costs may vary based on individual cases. Please consult a qualified doctor for medical advice and explore options within your budget before deciding on the procedure.