Complications of Neck Dissection

Head & neck cancer is the major problem due to its associated morbidity and mortality. It is the sixth most common cancers and the eighth cause of cancer mortality in the world(1). The most important prognostic factor in the management of head and neck cancer is the presence of cervical lymph node metastasis. Neck dissection has been a well‐established procedure for diagnosing (staging) and treating head and neck cancer for almost a century(2). This procedure is used to eradicate metastases to the regional lymph nodes of the neck. Since Crile introduced radical neck dissection at the beginning of the 20th century, a few changes have been proposed by Hays Martin in 1951 and Suárez which aimed for a more conservative approach to preserve vital anatomical structures in the neck without compromising the completeness of lymph node removal. The transition from radical to selective neck dissection has resulted in fewer complications and lower morbidity, at the same time preserving surgical efficacy and compliance with oncologic principles.(4) Depending on the location and extent of the tumor, the type of neck dissection performed may be radical, modified, selective and extended and either unilateral or bilateral. Complications of neck dissection affect every surgeon regardless of experience and technical skill. In addition to the various medical complications that may occur after any surgical procedure in head & neck region, a number of surgical complications may be related to the neck dissection. Complications of neck dissection are divided into three major categories: wound complications, Nerve complications, Vascular complications. Co-morbidities such as cardiac, respiratory and hepatic disease are common place in patients undergoing neck dissections in either an elective or therapeutic sense. Additional immunosuppression caused by conditions such as diabetes or relative malnutrition should be optimised since they predispose to complications including as wound infection. (5)