Before you agree to have your lymph node excision it is sensible to know all you can about it. The information here is a guide to common medical practice. Each hospital and doctor will have slightly different ways of doing things, so you should follow their guidance where it is different from the information given here. Because all patients, conditions and treatments vary it cannot cover everything. Use this information when making your lymph node treatment choices with your doctors. You should mention any worries you have. Remember that you can ask for more information at any time.
What is the problem?
The swelling in the side of your neck is due to enlarged lymph nodes, also called lymph glands.
Cervical lymph node excision
What is a lymph node?
Lymph nodes or glands are small swellings that help to fight infection. There are hundreds of them all over the body. There are a lot of lymph nodes in each side of the neck. Usually they are small and cannot be felt under the skin.
When they are actively fighting infection they swell up. For example, lymph nodes just under the jaw swell up in someone with tonsillitis. When the infection has gone the lymph nodes shrink back to their normal size.
Sometimes the nodes don’t shrink back to their normal size and stay enlarged. They are then called reactive lymph nodes.
Cervical lymph node excision 2
As well as infection, lots of other conditions make lymph nodes swell up. Sometimes tests may show why a lymph node is swollen but sometimes they may not.
A detailed ear, nose and throat examination by a specialist may reveal the cause of the lymph node swelling in the neck.
The aims
The aim of the operation is to completely remove one of the lymph nodes.
You will have a general anaesthetic and be completely asleep while this is done. Sometimes the operation can be done with just a local anaesthetic injection to numb the skin. This would depend on the size and exact position of the enlarged node.
The benefits
The lymph node will be examined in the laboratory to find out why it is swollen and to make sure no further treatment is needed.
Are there any alternatives?
A needle test (biopsy) may give the cause for the lymph node swelling. Sometimes the results are not reliable. The only way to get rid of the swelling is to remove it with an operation.
What if you do nothing?
If you do nothing the lymph nodes in the neck may stay the same or increase in size. If they get very big they may cause pain.
If you do nothing, and the reason for the enlarged lymph node is not known, you could be missing out on important treatment.
Who should have it done?
A person with enlarged lymph nodes in the neck, where the cause is unknown and other tests have not helped, should have the swelling removed.
Who should not have it done?
People who have other medical conditions that would make it unsafe for them to have a general anaesthetic should not have one. Sometimes the operation can be done with just a local anaesthetic injection to numb the skin. This would depend on the size and exact position of the enlarged node.
Author: Mr Robert Ruckley MB. ChB. F.R.C.S. Consultant ENT surgeon
© Dumas Ltd 2006
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