Lymph Nodes

Lymph (pronounced “limf”) nodes work as filters for our body fluid called lymph fluid. A problem, such as infection, injury, or cancer, will cause lymph nodes to swell as they work to filter out the “bad” cells. Lymph nodes are found in different parts of the body:

• Axillary nodes are under and around the armpit.

• Inguinal nodes are in the groin.

• Cervical nodes are in the head and neck area. Below is an image of the different levels of lymph nodes in the neck.

Cancer may start in your lymph nodes (i.e., lymphoma) or spread through the lymph system.

You may need a lymph node biopsy to figure out if you have lymph node cancer. A biopsy would mean removing 1-2 lymph nodes.

If there is a risk that cancer has spread to the lymph nodes in your neck, or if it has already spread, your treatment may include having a neck dissection.

Neck Dissection

A neck dissection is the removal of lymph nodes and nearby tissue from the neck.

Types of Neck Dissection

Radical Dissection: Remove lymph node groups 1 to 6, and surrounding structures.

Modified Dissection: Remove lymph node groups 1 to 6, while sparing one or more of the other surrounding structures.

Selective Dissection: Remove a select group of lymph nodes with or without other structures. This is the most common type of neck dissection.

A lymph node dissection can either be done by itself or at the same time you have surgery to remove any cancer.

Surgery

The surgery will take 1-3 hours and you will be under general anesthesia. Expect to stay in the hospital 1-2 nights.

What to Expect After Surgery

You will have an incision on your neck. You will have either dissolvable or non-dissolvable stiches to close your incision. Non-dissolvable stitches will be removed at your first post op visit. If your surgeon used dissolvable stiches, you may have white strip tapes over your incision called Steri-Strips™.

You may have drainage tubes on the affected side. Drainage tubes are removed 1-2 days after surgery.

You may have some numbness, tingling or decreased feeling in the jaw or neck. Be careful around extreme heat and cold. Use caution when using heating pads, ice packs and hair dryers. Be careful when shaving. You may feel a pulling in the neck muscles. You may have decreased strength or a drooping of your shoulder on the side of your surgery. This will get better but can last up to 6-8 weeks after surgery. You may be given some gentle exercises to do to help improve your strength in that arm.

Wound Care

You may shower 24 hours after the drainage tube is removed. Wash around the incision gently with soapy water, rinse and pat dry. Your surgeon will tell you if you should apply petroleum jelly (Vaseline®) to your incision.

No swimming or soaking in water for 14 days.

If you have Steri-Strips™ (pieces of tape) over the incision, leave them on until your next doctor visit. Curled tape edges may be trimmed with small scissors.

Seroma

A seroma is a fluid-filled bulge that forms under the skin where you had surgery. If you get a small seroma, your body will absorb this over time. If it gets larger and causes pain, contact your surgeon. This is not an emergency. You may need to have the fluid drained.

Pain

Expect that your wound will be tender.

• Use pain medicine as prescribed.

• Do not drive while taking narcotic pain medicine.

• Ask your surgeon if you can take ibuprofen, Advil®, Aleve® or naproxen.

• If you have nausea, take your pain medicine with food.

• Prevent constipation from pain medicines.

  • Eat plenty of fiber (bran, oats, fruits and vegetables).

  • Drink 6-8 glasses of water a day.

  • Take a stool softener, if needed.

Activity Guidelines

You can drive once you can move your head from side to side and you are no longer taking prescription pain medicine.

Light exercise, such as walking, is fine. Avoid strenuous exercise for 1-2 weeks. Avoid straining or extreme bending of your neck. Do not lift more than 20 pounds for the first week.

Keep your head raised at least 30 degrees for one week. Do not lie flat in bed. Use at least 2 pillows.

Returning to Work

Most people need to be off work for 1-2 weeks. If your job requires regular heavy lifting, you may require more time off. Please discuss this with your surgeon.

When to Call

• If you have trouble breathing, a sudden swelling in your throat, or cannot swallow, Call 911.

• Firmness or bruising.

• Heavy bleeding. Some oozing is common for a few days.

• Incision opens.

• Sudden increase in pain.

• Signs of infection like spreading redness or swelling, foul-smelling drainage or pus.

• Fever greater than 100.4 degrees F (38 degrees C) taken by mouth 2 times, 4 hours apart.

• A seroma that gets larger and is causing pain.

• Any other symptoms that concern you.

Who to Call

If your surgery was at University Hospital, call the ENT Clinic, Monday - Friday from 8:00 am - 5:00 pm, at (608) 263-6190.

After hours and weekends, the clinic number will give you the paging operator. Ask for the ENT doctor on-call. Leave your name, and phone number with area code. The doctor will call you back.

If your surgery was at UW Health East Madison Hospital call (608) 440-6300. This is a 24-hour number.

The toll-free number is 1-800-323-8942. Ask the operator to transfer you to the place where you had your surgery.

If your surgery was at Meriter or Madison Surgery Center, please call (608) 287-2100. This is a 24-hour number.