An Analysis of Complications of Neck Dissection in Head and Neck Cancers

Abstract

The neck dissection has remained a pivotal aspect of head and neck cancer management for over a century. During this time its role has expanded from a purely therapeutic option to an elective setting. Since vital anatomical structures are close, certain risks and complications are inherent to this procedure. Since neck surgery remains the most frequently performed form of therapeutic surgery in head and neck cancer irrespective of primary disease site, our objective is to report the complications in various types neck dissections and to seek improved outcome. A cross sectional retrospective study of 52 patients who underwent neck dissection from August 2015 to August 2019 was conducted to analyse intra operative and post-operative complications which aroused due to neck dissection. Indications for neck dissection depended on neck staging (N): selective neck dissection was done when evident disease was absent; Modified radical neck dissection was done if there was clinically evident neck node, preserving non-lymphatic neck structures (accessory nerve, internal jugular vein and internal jugular vein) as long as surgical completeness was not compromised. Bilateral neck dissection was indicated if contralateral disease was suspected or present. Out of 52 patients, one radical neck dissection, 14 modified radical and 37 selective neck dissection, of which 32 underwent supra omohyoid neck dissection and 5 underwent anterolateral and posterolateral neck dissection. The most frequent complication was marginal mandibular nerve injury (5.5%), followed by accessory nerve injury (2.1%). There was one death. A careful preoperative assessment of the patient, meticulous surgical techniques, good-quality postoperative care and appropriate rehabilitation are the cornerstones of preventing and managing complications of neck dissection.