Head-and-Neck Lymphedema

Head-and-neck lymphedema (HNL) is an increasingly recognized sequela of head-and-neck cancer treatment. Clinical manifestations affect both external and internal tissues. Patient impact can be significant, with major effects on function, aesthetics, and psychosocial status. Diagnosis is often made by history and physical exam, and patients can be followed with 3D scans for assessment of changes in volume. Conservative management is the mainstay of treatment in HNL and most frequently employs complete decongestive therapy. Patients with HNL refractory to conservative management may be candidates for surgical intervention. Lymphovenous bypass (LVB), although a novel treatment in HNL, has promising early results and may be a useful intervention in patients with earlier stages of HNL. Studies of the effects of LVB in HNL are ongoing.