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Neck dissection - discharge

  • Definition
    • Neck dissection is surgery to remove the lymph nodes in your neck. Cells from cancers in the mouth or throat can travel in the lymph fluid and get trapped in your lymph nodes. The lymph nodes are removed to prevent cancer from spreading to other parts of your body.

  • Alternative Names
    • Radical neck dissection - discharge; Modified radical neck dissection - discharge; Selective neck dissection - discharge

  • When You Were in the Hospital
    • You were likely to be in the hospital for 2 to 3 days. To help get ready for going home, you may have received help with:

      • Drinking, eating, and perhaps talking
      • Caring for your surgical wound in any drains
      • Using your shoulder and neck muscles
      • Breathing and handling secretions in your throat
      • Managing your pain
  • What to Expect at Home
    • Your health care provider will give you a prescription for pain medicines. Get it filled when you go home so you have the medicine when you need it. Take your pain medicine when you start having pain. Waiting too long to take it will allow your pain to get worse than it should.

      DO NOT take aspirin, ibuprofen (Advil, Motrin), or naproxen (Aleve, Naprosyn). These medicines may increase bleeding.

      You will have staples in the wound and mild redness and swelling for the first couple of weeks after surgery.

      You may have a drain in your neck when you leave the hospital. The nurse will tell you how to care for it.

      Healing time will depend on how much tissue was removed.

  • Diet and Nutrition
    • You can eat your regular foods unless your provider has given you a special diet.

      If pain in your neck and throat is making it hard to eat:

      • Take your pain medicine 30 minutes before meals.
      • Choose soft foods, such as ripe bananas, hot cereal, and moist chopped meat and vegetables.
      • Limit foods that are hard to chew, such as fruit skins, nuts, and tough meat.
      • If one side of your face or mouth is weaker, chew food on the stronger side of your mouth.

      Keep an eye out for swallowing problems, such as:

      • Coughing or choking, during or after eating
      • Gurgling sounds from your throat during or after eating
      • Throat clearing after drinking or swallowing
      • Slow chewing or eating
      • Coughing food back up after eating
      • Hiccups after swallowing
      • Chest discomfort during or after swallowing
      • Unexplained weight loss
  • Activity
      • You may move your neck gently sideways, up and down. You may be given stretching exercises to do at home. Avoid straining your neck muscles or lifting objects weighing more than 10 pounds (lbs) or 4.5 kilograms (kg) for 4 to 6 weeks.
      • Try to walk every day. You can return to sports (golf, tennis, and running) after 4 to 6 weeks.
      • Most people are able to go back to work in 2 to 3 weeks. Ask your provider when is it is OK for you to return to work.
      • You will be able to drive when you can turn your shoulder far enough to see safely. DO NOT drive while you are taking strong (narcotic) pain medicine. Ask your provider when it is OK for you to start driving.
      • Make sure your home is safe while you are recovering.
  • Other Self-care
    • You will need to learn to care for your wound.

      • You may get special antibiotic cream in the hospital to rub on your wound. Continue to do this 2 or 3 times a day after you go home.
      • You can shower after you return home. Wash your wound gently with soap and water. DO NOT scrub or let the shower spray directly on your wound.
      • DO NOT take a tub bath for the first few weeks after your surgery.
  • Follow-up
    • You will need to see your provider for a follow up visit in 7 to 10 days. The staples will be removed at this time.

  • When to Call the Doctor
    • Call your health care provider if:

      • You have a fever over 100.5°F (38.5°C).
      • Your pain medicine is not working to relieve your pain.
      • Your surgical wounds are bleeding, are red or warm to the touch, or have a thick, yellow, green, or milky drainage.
      • You have problems with the drain.
      • You cannot eat and lose weight because of swallowing problems.
      • You are choking or coughing when you eat or swallow
      • It is hard to breathe.
  • References
    • Robbins KT, Samnt S, Ronen O. Neck dissection. In: Flint PW, Haughey BH, Lund LJ, et al, eds. Cummings Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, PA: Elsevier Mosby; 2010:chap 121.