Modified radical neck dissection: What's your experience?

Posted by grandmother2 @grandmother2, Aug 12, 2023

Can someone share with me their experience with modified radical neck dissection? Schedule for surgery Sept. 20th!

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Hi@grandmother2! I have been curious about that terminology every time I read it. It SOUNDS like a total thyroidectomy, however if the issue is contained to one lobe why would someone need a radical removal. Have you had a procedure that diagnosed something? I have to admit the sound of “ radical” in any surgery sounds more concerning than “ lobectomy” or “ thyroidectomy.” You might want to ask what the doctor means so you are aware. If it’s just a nodule causing problems maybe you could ask about radio frequency ablation (RFA). …. Doctors who do not do RFA might not offer it as an option, however it prevents removal of thyroid. Definitely worth a google search to read about. Good luck!

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I had a total Thyroidectomy done back in September 2005 due to cancer. I had one RAI treatment. I've been on synthroid ever since. I go to my endocrinologist faithfully. Recently I found a lump on the right side of my neck. I went to my new endocrinologist who told me not to worry about it and that it will go away in a few weeks. The very next day I had an appointment with my primary care doctor for a different issue. When I mentioned the lump on my neck they sent me for a scan immediately. It was then recommended that I see a surgeon and get the lump biopsied. The biopsy came back - METASTATIC PAPILLARY THYROID CARCINOMA. POSITIVE FOR MALIGNANT CELLS. Obviously, not what i wanted to hear. Then met with surgeon who said the cancer was in the lymph nodes on the right side of my neck. At this time, the rest of the neck appeared fine. So, I'm scheduled for a modified neck dissection on the right to remove the malignant lymph nodes. I'm curious to know what others who have gone through this prepared for the surgery, how they did after the surgery, and what can I do to hopefully make the entire experience less traumatic.

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@grandmother2

I had a total Thyroidectomy done back in September 2005 due to cancer. I had one RAI treatment. I've been on synthroid ever since. I go to my endocrinologist faithfully. Recently I found a lump on the right side of my neck. I went to my new endocrinologist who told me not to worry about it and that it will go away in a few weeks. The very next day I had an appointment with my primary care doctor for a different issue. When I mentioned the lump on my neck they sent me for a scan immediately. It was then recommended that I see a surgeon and get the lump biopsied. The biopsy came back - METASTATIC PAPILLARY THYROID CARCINOMA. POSITIVE FOR MALIGNANT CELLS. Obviously, not what i wanted to hear. Then met with surgeon who said the cancer was in the lymph nodes on the right side of my neck. At this time, the rest of the neck appeared fine. So, I'm scheduled for a modified neck dissection on the right to remove the malignant lymph nodes. I'm curious to know what others who have gone through this prepared for the surgery, how they did after the surgery, and what can I do to hopefully make the entire experience less traumatic.

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Hi.

I am sorry to hear you are going through this. I just had a neck dissection a few weeks ago. I also had my thyroid removed (6 years ago) but an ultra sound in the spring showed enlarged lymph nodes that turned out to be malignant.

There is pretty accurate information when you Google it, but I will give you some info about my experience. I had a lateral and central neck dissection. Initially it was supposed to just be a left lateral dissection but after the pre op CT scan they realized that the central lymph nodes were malignant as well. My incision starts about two inches under my ear and goes down and around to the front of my neck (pretty much where my scar was from having two hemithyroidectomies). There was definitely discomfort in the first ten days, but not enough for me to use any pain medication (including OTC like Tylenol). Now three and a half weeks out I still have areas of tenderness but nothing that impacts my day to day activities. The incision is healing well. I am in my early 50s. I think by the time it is fully healed it will look more like a wrinkle/sag in my neck skin.

There are rare complications that you can read about (shoulder, lip, tongue). I did not have any of those. Some lymph nodes had attached to my recurrent laryngeal nerve. The surgeon tested that the signals were traveling through my nerves throughout the surgery, so the nerve isn’t damaged, but due to being manipulated, it needs time to recover. The consequence of that is the paralysis of my left vocal cord. I currently have a very hoarse , breathy voice. Sometimes I cough and choke on drinks, but not often. There is an injection that plumps up the vocal cord so it stays closed so you can talk and eat comfortably. It wears off in about a year which is about the time the healing should happen. I will be getting the injection in 10 days. I could have had it sooner but I am having some more testing done and I wanted to get that done first.

All in all I had 32 lymph nodes removed (8 were malignant).

I hope that information helps. I wish you the best in your recovery!

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@maryny23

Hi.

I am sorry to hear you are going through this. I just had a neck dissection a few weeks ago. I also had my thyroid removed (6 years ago) but an ultra sound in the spring showed enlarged lymph nodes that turned out to be malignant.

There is pretty accurate information when you Google it, but I will give you some info about my experience. I had a lateral and central neck dissection. Initially it was supposed to just be a left lateral dissection but after the pre op CT scan they realized that the central lymph nodes were malignant as well. My incision starts about two inches under my ear and goes down and around to the front of my neck (pretty much where my scar was from having two hemithyroidectomies). There was definitely discomfort in the first ten days, but not enough for me to use any pain medication (including OTC like Tylenol). Now three and a half weeks out I still have areas of tenderness but nothing that impacts my day to day activities. The incision is healing well. I am in my early 50s. I think by the time it is fully healed it will look more like a wrinkle/sag in my neck skin.

There are rare complications that you can read about (shoulder, lip, tongue). I did not have any of those. Some lymph nodes had attached to my recurrent laryngeal nerve. The surgeon tested that the signals were traveling through my nerves throughout the surgery, so the nerve isn’t damaged, but due to being manipulated, it needs time to recover. The consequence of that is the paralysis of my left vocal cord. I currently have a very hoarse , breathy voice. Sometimes I cough and choke on drinks, but not often. There is an injection that plumps up the vocal cord so it stays closed so you can talk and eat comfortably. It wears off in about a year which is about the time the healing should happen. I will be getting the injection in 10 days. I could have had it sooner but I am having some more testing done and I wanted to get that done first.

All in all I had 32 lymph nodes removed (8 were malignant).

I hope that information helps. I wish you the best in your recovery!

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Thank you so much for sharing your experience. I have to be honest, I'm petrified. The procedure sounds horrible. Is there anything I can do to prepare for surgery? Exercises? Special pillow or chair? Anything to make this procedure and recovery as "easy" as possible. I really appreciate any and all suggestions. 18 yrs since I had my thyroid removed due to cancer. This happening 18 yrs later is throwing me for a loop!

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I felt the same way…shocked it had come back and petrified. The surgery and recovery was MUCH easier than I anticipated. I was only in the hospital for one night (which my insurance has refused to pay for because they said it was “not medically necessary”). I forgot to mention that they put a drain (tube) in my neck to collect fluid from the area. That is why I stayed overnight. Because it was a more extensive surgery than they originally anticipated, they wanted to make sure there wasn’t too much fluid draining out. (There wasn’t much.). I was very concerned about lymphedema, but they said that it generally is not an issue unless you have lymph nodes removed from both sides of your neck.

I don’t think there is anything you can do to prepare for it. I completely understand how stressful it is, but it sounds like your doctor was very proactive in addressing it, so you seem to be in great hands!

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@koh

Hi@grandmother2! I have been curious about that terminology every time I read it. It SOUNDS like a total thyroidectomy, however if the issue is contained to one lobe why would someone need a radical removal. Have you had a procedure that diagnosed something? I have to admit the sound of “ radical” in any surgery sounds more concerning than “ lobectomy” or “ thyroidectomy.” You might want to ask what the doctor means so you are aware. If it’s just a nodule causing problems maybe you could ask about radio frequency ablation (RFA). …. Doctors who do not do RFA might not offer it as an option, however it prevents removal of thyroid. Definitely worth a google search to read about. Good luck!

Jump to this post

Hello,
I had a modified, radical neck resection and yes, the name is daunting! In my case and I’m not sure it’s true for everyone, is much more than thyroidectomy as they remove tissue, lymph nodes and skeletonize nerves. Scar goes from behind my ear to middle of neck where thyroid would be. In my case I had complications as I had the accessory nerve injury too. You can google that😊
Surgery left me with a permanent disability, not being able to raise my arm over my head. 18 yrs and cancer free.. so I’m going with that theme!

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Thank you for sharing. Anything I can do to prepare? Did you sleep on recliner? Were you able to eat? Drive?

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@grandmother2

Thank you for sharing. Anything I can do to prepare? Did you sleep on recliner? Were you able to eat? Drive?

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I can’t say that there is anything to prepare yourself except try to be calm.. haha.. not very easy. Know that you are in good hands. I slept in a recliner for several weeks, comfort was not my friend. The only other thing I would mention are the chest drains. When they come to remove them ask for something for pain awhile prior. Mine had been in for 5 days so they hurt like hell coming out. I was not prepared!😢
Best to you!💕 Without going back to your post I can’t remember when you go in.

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Thank you. Surgery is scheduled for Sept 20th. Not looking forward to this as I know you probably felt the same way. I will continue to ask questions of group as they come up. Thank you again.

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You will do fine. Have faith in your medical team. Positive vibes and a big hug coming your way. ❤️
Please keep me posted.

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