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CC BY-NC-ND 4.0 · Int Arch Otorhinolaryngol 2023; 27(02): e329-e335
DOI: 10.1055/s-0042-1745726
Original Research

Inpatient Decongestive Therapy for Lymphedema in Acute Postsurgical Head and Neck Cancer Patients*

John Christian Lemoine 
1   Department of Otolaryngology, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, Louisiana, United States
,
Vilija Vaitaitis
2   Department of Otolaryngology – Head & Neck Surgery, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, Louisiana, United States
,
Trisha Jarreau
3   Department of Speech and Language Pathology, Our Lady of the Lake Regional Medical Center, Baton Rouge, Louisiana, United States
,
Joel St. Germain
3   Department of Speech and Language Pathology, Our Lady of the Lake Regional Medical Center, Baton Rouge, Louisiana, United States
,
Leslie Son 
4   Department of Otolaryngology, Our Lady of the Lake Regional Medical Center, Louisiana, United States
,
Anna M. Pou
5   Department of Otolaryngology, Ochsner Health Center – Covington, Covington, Louisiana, United States
,
Ashley Mays 
2   Department of Otolaryngology – Head & Neck Surgery, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, Louisiana, United States
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Abstract

Introduction Head and neck lymphedema is an omnipresent morbidity related to head and neck cancer therapies. Studies on therapy for these patients in the acute postsurgical population have not been published to date.

Objective To assess changes in the measurements of lymphedema in surgical head and neck cancer patients during the hospital stay with implementation of modified decongestive therapy (MDT).

Methods Patients aged > 18 years undergoing neck dissection with or without primary-site resection or laryngectomy between 2016 and 2019 were included. Facial measurements were obtained prior to beginning MDT and again prior to discharge. A total facial composite measurement was calculated and used to assess change over time. Rates ≥ 2% of change were considered significant.

Results A total of 38 patients were included (subsites: larynx = 27; thyroid = 4; oral cavity = 3; and neck = 4). The mean number of days between surgery and the start of lymphedema therapy was 3.0 days. The mean number of days between measurements was 5.2 days. Reduction in the total composite score was observed in 37 (97%) patients, and 35 (92%) patients had a total composite reduction score > 2%. Tumor subsite and surgery type did not portend toward greater percent change, except for those patients treated with total laryngectomy, regional flap reconstruction, and neck dissection (p = 0.02).

Conclusion Acute postsurgical inpatient MDT was associated with reduced total composite measurements in patients after head and neck surgery. As the first published study on lymphedema therapy in this acute postsurgical period, further prospective case-control studies are warranted to explore further benefits of acute therapy.

Keywords

lymphedema - complete decongestive therapy - head and neck cancer - head and neck surgery - manual lymph drainage

* Presented at the Academy of American Otolaryngologists – Head and Neck Surgery Foundation 2018 Annual Meeting in Atlanta, GA, October 6-10, 2018.




Publication History

Received: 09 November 2021

Accepted: 14 February 2022

Article published online:
28 April 2023

© 2023. Fundação Otorrinolaringologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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