Cervicofacial and Pharyngolaryngeal Lymphedema and Deglutition After Head and Neck Cancer Treatment

AbstractOne of the sequelae of head and neck cancer treatment is secondary lymphedema, with important impact on breathing, swallowing and vocal functions. The aim of the study was to assess the presence, staging characteristics and relationship of external and internal lymphedema and dysphagia after head and neck cancer treatment. The MDACC Lymphedema Rating Scale in Head and Neck Cancer was employed for the assessment and staging of face and neck lymphedema; the Radiotherapy Edema Scale for internal lymphedema; and a fiberoptic endoscopic evaluation of swallowing (FEES) for swallowing. The sample consisted of 46 patients with a diagnosis of head and neck cancer. Lymphedema was detected in 97.8% (45) of the evaluations with predominance of the composite type (73.9% —34). A high percentage of external lymphedema of the neck (71.7%—33) and submandibular (63%—29) were detected, with predominance of the more advanced levels. Internal edema was found in almost all structures and spaces at moderate/severe level. At FEES, residue (higher percentage in vallecula e and pyriform sinus), penetration and aspirations were observed. The residue was detected in higher occurrence in patients with composite lymphedema (p = 0.012). The combined treatment with radiotherapy was related to submandibular external lymphedema (p = 0.009), altered pharyngolaryngeal sensitivity (0.040), presence of residue (p = 0.001) and penetration to pasty...
Source: Dysphagia - Category: Speech-Language Pathology Source Type: research

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The original version of this article unfortunately contained a mistake. Figure 2 was repeated in Figure 3.
Source: Dysphagia - Category: Speech-Language Pathology Source Type: research
ConclusionEvidence for the efficacy of all types of lymphedema therapy is limited by paucity of large randomized controlled trials. While manual lymph drainage is best studied, liposuction and surgical treatments have also been effective in a small number of patients.
Source: American Journal of Otolaryngology - Category: Endocrinology Source Type: research
This patient page describes the causes, symptoms, and treatment of lymphedema in patients treated with surgery or radiation therapy for head and neck cancer.
Source: JAMA Otolaryngology - Head and Neck Surgery - Category: ENT & OMF Source Type: research
ConclusionsThe study has underscored the potential benefit of lymphedema therapy in the head and neck cancer population. Substantial barriers to therapy were reported and need to be addressed. Opportunities to improve lymphedema therapy outcomes were suggested. Personalized strategies should be considered for ensuring optimal patient outcomes.
Source: Supportive Care in Cancer - Category: Cancer & Oncology Source Type: research
Recently, an article was published in the Leader about my work with patients with head or neck cancer. The response has been great, with the most-asked question being about the pathway I created to help patients and caregivers navigate through and receive improved access to care. How did I create this pathway? The first thing I did was listen to patients and caregivers discuss what they wished they knew before treatment started. After years of listening, I realized something had to change for them. From this realization came the idea of designing a pathway so all treating partners—as well as patients and caregivers&m...
Source: American Speech-Language-Hearing Association (ASHA) Press Releases - Category: Speech-Language Pathology Authors: Tags: Health Care Slider Speech-Language Pathology Dysphagia Source Type: blogs
Recently, an article was published in the Leader about my work with patients with head or neck cancer. The response has been great, with the most-asked question being about the pathway I created to help patients and caregivers navigate through and receive improved access to care. How did I create this pathway? The first thing I did was listen to patients and caregivers discuss what they wished they knew before treatment started. After years of listening, I realized something had to change for them. From this realization came the idea of designing a pathway so all treating partners—as well as patients and caregivers&m...
Source: American Speech-Language-Hearing Association (ASHA) Press Releases - Category: Speech-Language Pathology Authors: Tags: Health Care Slider Speech-Language Pathology Dysphagia Source Type: blogs
Lymphatic Research and Biology, Ahead of Print.
Source: Lymphatic Research and Biology - Category: Biology Authors: Source Type: research
Authors: Anand A, Balasubramanian D, Subramanian N, Murthy S, Limbachiya S, Iyer S, Thankappan K, Sharma M Abstract Secondary head and neck lymphedema (SHNL) is a chronic condition affecting patients who have undergone treatment for head and neck cancers. It results from the disruption of normal lymphatic flow by surgery and/or radiation. The incidence of secondary head and neck lymphedema varies anywhere between 12 and 54% of all patients treated for head and neck cancer, but it is still commonly under-diagnosed in routine clinical practice. In spite of awareness of this condition, treatment has been difficult as ...
Source: Lymphology - Category: Internal Medicine Tags: Lymphology Source Type: research
Conditions:   Head and Neck Cancer;   Lymphedema;   Fibrosis Intervention:   Device: Low-Level Laser Sponsor:   University of Pennsylvania Recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
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