There are approximately 300 to 500 lymph nodes in the head and neck region. In order to more easily classify them, they are arranged into groups. Within the neck, lymph nodes are divided from level 1 – 6, according to the diagram below.

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We also know from a great deal of research, that certain types of tumors can metastasize or spread to particular levels in the neck. For example, tumors of the tongue will generally involve levels 1, 2, and 3. Tumors of the tonsils will commonly involve levels 2, 3, and 4. Thyroid cancers typically involve level 6, although they may also involve levels 3, 4, and sometimes 5.

Neck dissection refers to the systematic surgical excision or removal of these nodal groups in order to treat the lymph nodes that are at most risk for spread of malignancy in the setting of a cancer of the head and neck. The idea is that you preserve as much function as possible by not removing lymph nodes that are not usually involved with cancer, and treating only those that need to be treated.

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