Preliminary Experience With Head and Neck Lymphedema and Swallowing Function in Patients Treated for Head and Neck Cancer

Abstract

Lymphedema is a collection of high protein fluid in the interstitial tissues that results from trauma, infection, or oncologic treatment that impairs lymphatic drainage. The damaging effects of radiation therapy and surgery on the lymphatic system primarily include edema and fibrosis. Lymphedema most often is recognized as a potentially serious complication for patients with breast, gynecological, or genitourinary cancers that manifests as swelling of the extremities. However, lymphedema in the head and neck region is a common complication of treatments for head and neck cancer. When lymphedema involves the head and neck region, the cosmetic and functional sequelae may be significant. Potential side effects include problems with drooling, mastication, deglutition, articulation, airway obstruction, and poor self image. The potential effects of head and neck lymphedema on swallowing function have not been well-documented and are only recently recognized. Oral preparation and pharyngeal transit are likely most affected. Complete Decongestive Therapy (CDT) is the international standard of care for treating lymphedema of the extremities that combines manual lymphatic drainage (MLD), bandage compression, skin care, and targeted exercise. Preliminary evidence supports the effectiveness of CDT in patients with head and neck lymphedema after cancer treatment.