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Lymphedema Therapy for the Head & Neck

Lymphedema of the Head/Neck

Secondary lymphedema of the head and neck region is a common late effect of various cancer treatments, surgery or a combination of surgery and radiation treatments. Lymphedema is caused by the disruption of lymphatic flow following lymph node dissection, tumor removal, and radiation therapy of the affected areas. The impaired lymphatic flow can be further reduced by the presence of fibrosis (scar tissue) in the surrounding tissues.

The presence of lymphedema in the facial/neck region area has a great emotional, self esteem consequence as it can be very disfiguring leading to embarrassment and depression. It can be very disfiguring to the patient, which can lead to functional problems for the patient. If the swelling is present in the eye lids there can be reduced vision, swelling may occur both internally and externally around the mouth affecting swallowing, speech, breathing and difficulty eating (keeping food in the mouth/drooling). Nasal congestion can be present due to swelling

Lymphedema in head/neck patient tends to be worse in evening when the patient is lying down or in the early morning hours when they just awaken. The postural position of being upright, takes advantage of the gravitational forces pulling downward toward the chest/back regions. Therefore, sleep position (semi upright to counter gravity) is very important in helping with keeping the airway open and reduce swelling to the region.

The goals for treatment are to reduce the swelling, prevent infection, improve the appearance of the person, and to improve the patient’s ability to function. Lymphedema is treatable but there is no cure at present. The gold standard of care for lymphedema treatment is complex decongestive therapy which incorporates manual lymphatic drainage, specific exercises, skin care and sufficient compression which may include compression garments (neck/chin straps, facial mask partial or full).

The manual lymphatic drainage facilitates the movement of lymphatic fluid away from the congested areas, through lymphatic vessels/pathways,to areas with sufficient (collateral) lymphatic drainage which have not been damaged. Upon completion of treatment the therapist will advise the patient on a home self care program of self massage that will help prevent infection and manage their lymphedema.