When this occurs, removal of the affected lymph nodes is necessary, and the tissue is sent for histopathological examination.<\/span><\/p>\n<\/div>\n<\/div>\n[\/vc_column_text][\/vc_tta_section][vc_tta_section title=”Does Cancerous Infiltration of Lymph Nodes Cause Symptoms” tab_id=”1615975445991-abbe6e0b-76e0″][vc_column_text]Unfortunately,<\/b> in the majority of cases, <\/span>patients do not experience any warning symptoms.<\/b> Often, <\/span>there are no visible neck swellings either<\/b>. Therefore, <\/span>clinical examination<\/b> and, most importantly, <\/span>ultrasound imaging<\/b> are essential to identify affected lymph nodes.<\/span>[\/vc_column_text][\/vc_tta_section][vc_tta_section title=”What Tests Can Identify Lymph Node Involvement” tab_id=”1615975481588-25200828-4edd”][vc_column_text]Ultrasound<\/b> is a critical preoperative examination that the surgeon must have. Radiologists usually provide information on whether there are any suspicious or pathologically enlarged lymph nodes.<\/span><\/p>\nSuspicious lymph nodes may undergo fine-needle aspiration (FNA) for cytological examination to confirm malignancy. <\/b>In many cases, however, the ultrasound findings alone are sufficient to proceed directly to surgery without FNA.<\/span><\/p>\nFor confirmed thyroid cancer cases, optional preoperative <\/span>lymph node mapping<\/b> may be performed by <\/span>specialized radiologists<\/b> to provide detailed anatomical information.<\/span>[\/vc_column_text][\/vc_tta_section][vc_tta_section title=”Are All Removed Lymph Nodes Cancerous” tab_id=”1615975590436-b57265fb-fab9″][vc_column_text]<\/p>\n\n
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The endocrine surgeon removes all lymphatic and fatty tissue in the area, not just visibly affected nodes.<\/b> Microscopic examination will determine <\/span>which lymph nodes, if any, contain cancer.<\/b> Removing normal lymph nodes <\/span>does not negatively impact health.<\/b><\/p>\n<\/div>\n<\/div>\n[\/vc_column_text][\/vc_tta_section][vc_tta_section title=”What Types of Lymph Node Dissection Surgeries Are There” tab_id=”1615975556038-9e4b248f-329d”][vc_column_text]There are two main types:<\/span><\/p>\n\n- Central <\/b>lymph node dissection<\/span><\/li>\n
- Lateral <\/b>lymph node dissection (unilateral or bilateral)<\/span><\/li>\n<\/ul>\n
[\/vc_column_text][\/vc_tta_section][vc_tta_section title=”Is the Surgery Difficult” tab_id=”1615976016751-0a946bcb-71fc”][vc_column_text]Cervical lymph node dissection (especially lateral) <\/span>is among the most complex surgeries in the neck.<\/b> The specialized surgeon must <\/span>carefully and precisely remove the lymph nodes,<\/b> which are literally \u201centangled\u201d among vital anatomical structures. Therefore, on one hand, a thorough oncologic clearance must be achieved, while on the other hand, <\/span>important and delicate neck structures must be carefully preserved. These include the parathyroid glands, the recurrent laryngeal nerves, the carotid arteries, the internal jugular veins, the thoracic duct (on the left), the minor thoracic duct (on the right), as well as crucial nerves<\/b> such as the vagus, phrenic, hypoglossal, accessory nerves, the brachial plexus, and the cervical plexus.<\/span>[\/vc_column_text][\/vc_tta_section][vc_tta_section title=”Is there a Specialized Surgeon for this Procedure” tab_id=”1615976104393-438a3c43-b7c5″][vc_column_text]Certainly, a cervical lymph node dissection <\/span>should ideally be performed by a surgeon specialized in endocrine surgery.<\/b> On one hand, the primary goal is to achieve a <\/span>complete and thorough removal <\/b>of malignant tissue, ensuring the oncologic effectiveness of the procedure. On the other hand, it is essential to <\/span>minimize the risk of serious complications reported in the literature,<\/b> such as hematoma, nerve injury, tracheal or esophageal damage, parathyroid injury, pneumothorax, air embolism, chyle leak, surgical site infection, and skin flap necrosis.<\/span>[\/vc_column_text][\/vc_tta_section][vc_tta_section title=”How Long Does the Surgery Take, What Type of Anesthesia is Used, and What is the Recovery Like” tab_id=”1615976152058-1fb10f02-c563″][vc_column_text]For a <\/span>central cervical lymph node dissection<\/b>, the procedure is <\/span>similar to a total thyroidectomy<\/b>. In the case of a lateral cervical lymph node dissection, which is a more complex surgery, there are some <\/span>differences.<\/b> General anesthesia<\/b> is required and is <\/span>safe.<\/b> The <\/span>duration<\/b> of the surgery can <\/span>range from 3 hours to longer<\/b>, depending on the <\/span>extent of the disease<\/b> and the <\/span>surgical challenges<\/b> in each patient. The surgical <\/span>incision <\/b>is <\/span>slightly larger<\/b> to provide the surgeon with proper <\/span>anatomical access to the suspicious lymph nodes,<\/b> while also ensuring the <\/span>best possible cosmetic result<\/b>. <\/span>The placement of a drainage tube is more likely<\/b> than in standard thyroidectomy procedures, but it is usually <\/span>removed painlessly within 1\u20132 days<\/b>. The<\/span> need for blood transfusion<\/b> is <\/span>extremely rare.<\/b><\/p>\nAfter surgery, patients can speak, eat lightly, and begin moving on the same day. <\/span>Pain is generally minimal<\/b> and is usually managed with <\/span>simple analgesics, such as acetaminophen<\/b>, which most patients do not need to continue at home. <\/span>Hospitalization<\/b> typically lasts <\/span>1\u20132 days<\/b> in the majority of cases.<\/span>[\/vc_column_text][\/vc_tta_section][vc_tta_section title=”Are There Modern Techniques and Tools for the Surgery” tab_id=”1615976199009-15cf9489-9ec0″][vc_column_text]Cervical lymph node dissection is an oncologic procedure, where the surgeon\u2019s <\/span>primary goal is the thorough removal of malignant tissue.<\/b> At the same time, we place great importance on secondary goals, such as achieving the <\/span>best possible cosmetic outcome and ensuring a fast, painless recovery <\/b>for our patient<\/span>.<\/b> This is achieved by applying principles of <\/span>minimally invasive surgery<\/b> without compromising the radicality of the procedure.<\/span><\/p>\nComprehensive preoperative ultrasound mapping of the neck,<\/b> often with repeated imaging during surgery using <\/span>portable sonography, <\/b>provides essential information for a more <\/span>complete and successful lymph node<\/b> dissection in cases of malignancy.<\/span><\/p>\nMaximum surgical precision and effectiveness are achieved with modern tools such as <\/span>radiofrequency <\/b>and <\/span>ultrasonic devices (Ultracision),<\/b> instead of traditional scalpels. These technologies allow for a more thorough removal of metastatic lymph nodes, better hemostasis, and reduced postoperative pain. Patient speech is safeguarded through the use of <\/span>neuromonitoring. <\/b>This revolutionary and highly useful technique alerts the surgeon to protect the vocal cords, providing a high degree of safety. In lateral lymph node dissections, the anatomical course of not only the laryngeal nerves but also the vagus nerves is revealed, giving the surgeon a more complete view for vocal cord protection.<\/span><\/p>\nAt our Center, we use either <\/span>intermittent<\/b> or <\/span>continuous neuromonitoring<\/b>. In continuous monitoring, the nerve signals for the vocal cords are tracked throughout the surgery. <\/span>Video-laryngoscopy <\/b>is also employed to verify vocal cord mobility, adding another layer of safety.<\/span><\/p>\nDuring this highly demanding surgery, specialized equipment with precision magnifying lenses (<\/span>surgical loops) <\/b>\u00a0gives the surgeon a <\/span>detailed view of the surgical field. <\/b>Careful dissection, sometimes combined with marking techniques, <\/span>ensures and protects the adjacent parathyroid glands.<\/b>[\/vc_column_text][\/vc_tta_section][vc_tta_section title=”Will There Be a Scar on My Neck” tab_id=”1615976245890-84af2470-7a35″][vc_column_text]The <\/span>incision<\/b> is made with meticulous care, following the <\/span>natural skin folds of the neck, ensuring the best possible cosmetic outcome.<\/b> No suture removal is required, as the <\/span>technique allows for a plastic closure<\/b> of the wound at the end of the surgery.<\/span><\/p>\nThis technique has been significantly refined by Dr. Karvounis to minimize the visibility of scars without compromising the thoroughness of the procedure<\/b>. <\/span>Special dermatological creams<\/b> may be recommended to support skin <\/span>healing,<\/b> resulting in a <\/span>fine, barely visible scar or, <\/b>in some cases,<\/span> no visible scar at all, <\/b>depending on skin type and healing.<\/span>[\/vc_column_text][\/vc_tta_section][vc_tta_section title=”When Can I Return to Work” tab_id=”1615976319511-f293f35c-5a98″][vc_column_text]<\/p>\n\n
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Recovery <\/b>after thyroid surgery is usually <\/span>quick<\/b> and<\/span> without significant postoperative pain.<\/b> Many patients return to work <\/span>within a few days of discharge<\/b>, especially if their job does not involve physical strain.<\/span><\/p>\nDepending on the <\/span>nature of the work<\/b> and individual needs, a <\/span>medical leave<\/b> may be advised. In such cases, the duration of absence is determined in <\/span>consultation with the doctor<\/b> to ensure the patient returns safely and comfortably to daily activities.<\/span><\/p>\n<\/div>\n<\/div>\n[\/vc_column_text][\/vc_tta_section][vc_tta_section title=”If the Biopsy Shows Malignancy in the Lymph Nodes, Will I Need Iodine” tab_id=”1615976710881-0ea742dd-293e”][vc_column_text]If the histological examination after surgery confirms the presence of <\/span>malignant lymph nodes<\/b>, this <\/span>does not necessarily indicate a serious concern<\/b>. The most common type of thyroid cancer, <\/span>papillary thyroid carcinoma<\/b>, is generally <\/span>highly treatable <\/b>and <\/span>responds very well<\/b> to therapy, even when lymph nodes are involved.<\/span><\/p>\nThe need for <\/span>additional radioactive iodine (\u00b9\u00b3\u00b9I) therapy<\/b> is assessed in consultation with the treating <\/span>endocrinologist,<\/b> based on the histology results and other prognostic factors. In many cases, <\/span>radioactive iodine is administered in tablet form<\/b>, without the need for chemotherapy or external radiation, as is required for some other cancers.<\/span><\/p>\nThis treatment is accompanied by a <\/span>scintigraphic evaluation<\/b> and simple precautions, such as <\/span>avoiding close contact with pregnant women and infants for a few days<\/b>. In rarer forms, such as <\/span>medullary thyroid carcinoma<\/b>, the therapeutic approach is individualized.<\/span><\/p>\nThe most important step, however, remains the <\/span>timely and complete surgical removal of the tumor<\/b>. This is the <\/span>fundamental basis<\/b> for successful management of any thyroid malignancy.<\/span>[\/vc_column_text][\/vc_tta_section][vc_tta_section title=”What is the Process for a Lateral Cervical Lymph Node Dissection” tab_id=”1615976770165-ae8e6503-40c6″][vc_column_text]The procedure is carefully planned to <\/span>minimize discomfort for the patient <\/b>while ensuring<\/span> the highest standard of medical care.<\/b> With the support of our experienced medical team, <\/span>each case is approached individually, <\/b>with full responsibility and scientific accuracy.<\/span><\/p>\nThe process begins with an <\/span>initial surgical evaluation,<\/b> either <\/span>in-person at the clinic<\/b> or through a <\/span>detailed telephone consultation<\/b>. In many cases, patients are asked to <\/span>send medical examinations <\/b>via email for an initial assessment.<\/span><\/p>\nFor proper preoperative preparation of a <\/span>lateral cervical lymph node dissection<\/b>, the following steps are essential:<\/span><\/p>\n\n- ENT evaluation of vocal cord mobility<\/b>, ideally performed by a specialized phoniatrist in collaboration with our clinic<\/span><\/li>\n
- Detailed ultrasound mapping of the cervical lymph nodes<\/b> by an experienced radiologist<\/span><\/li>\n
- Timely coordination with the clinic\u2019s administration<\/b>