Suprahyoid lymphadenectomy
CPT4 code
Name of the Procedure:
Suprahyoid Lymphadenectomy
Summary
Suprahyoid lymphadenectomy is a surgical procedure to remove lymph nodes located above the hyoid bone in the neck. This area includes the lymph nodes around the floor of the mouth, the sides of the tongue, and the lower jaw.
Purpose
This procedure is primarily performed to treat cancer that has spread to the lymph nodes in the neck, such as oral cancer, throat cancer, or other head and neck malignancies. The goal is to remove affected lymph nodes to prevent further spread of cancer.
Indications
- Presence of metastatic cancer in the lymph nodes of the suprahyoid region.
- Diagnosis of head and neck cancers such as oral or throat cancer with lymph node involvement.
- Recurrent cancer in previously treated areas.
Preparation
- The patient may be instructed to fast for at least 8 hours before the surgery.
- Pre-operative blood tests, imaging studies (like CT scans or MRIs), and possibly a biopsy may be required.
- Adjustments to medications, especially blood thinners, will need to be made as directed by the healthcare provider.
Procedure Description
- General anesthesia is administered to ensure the patient is asleep and pain-free.
- An incision is made in the neck above the hyoid bone to access the lymph nodes.
- The surgeon carefully dissects and removes the lymph nodes while avoiding damage to surrounding structures.
- Hemorrhage control is maintained, and the incision is closed using sutures or staples.
- Drains may be placed to prevent fluid accumulation and are typically removed a few days post-surgery.
Duration
The procedure typically takes about 2 to 4 hours, depending on the extent of lymph node involvement and the patient’s anatomy.
Setting
Suprahyoid lymphadenectomy is performed in a hospital operating room.
Personnel
- Head and neck surgeon
- Surgical nurse
- Anesthesiologist
- Operating room technician
Risks and Complications
- Infection
- Bleeding or hematoma formation
- Nerve injury leading to numbness or weakness in the tongue or lower lip
- Difficulty swallowing or changes in voice
- Scarring
Benefits
- Removal of cancerous lymph nodes can help stop cancer from spreading to other parts of the body.
- Improved chances of survival and potentially a cure for head and neck cancers.
- Reduction of tumor burden can aid in the effectiveness of other treatments like radiation or chemotherapy.
Recovery
- The patient will need to stay in the hospital for a few days for monitoring.
- Pain management will be provided with medications.
- Patients should avoid strenuous activities and follow a soft food diet initially.
- Follow-up appointments are necessary to monitor healing and discuss any additional treatments.
- Full recovery can take several weeks, with gradual resumption of normal activities.
Alternatives
- Radiotherapy: Less invasive but may not be sufficient alone for advanced cancer.
- Chemotherapy: Often used in conjunction with surgery or radiation.
- Observation: May be an option for small, slow-growing cancers, though it carries risks of progression.
Patient Experience
Patients can expect to feel soreness and discomfort in the neck post-surgery, which will be managed with pain relief medication. Swelling and bruising are common and generally resolve with time. The presence of a drain might cause slight inconvenience until it is removed, typically within the first week after surgery. Regular follow-ups and wound care are essential to ensure optimal recovery and early detection of any complications.