Central and Lateral Neck Dissection: Techniques and Potential Complications

All subtypes of thyroid cancer can metastasize to the cervical lymph nodes. When there is nodal involvement, compartmental surgical excision of the nodes is the first-line treatment. The cervical lymph nodes are traditionally organized into anatomical compartments. The central neck is bounded laterally by the carotid arteries. The lateral neck nodes involved in thyroid cancer are usually bounded by the clavicle and spinal accessory nerve. The anatomy and techniques involved in central and modified radical neck dissection are reviewed. Complications that can arise from neck dissection, including vascular injury, nerve injury, chyle leak, hypocalcemia, and hypoparathyroidism, are discussed along with the recommended approach to management.