Lymphoedema Evidence Library › Topics › Head and neck lymphoedema
Head and neck lymphoedema
Head and neck lymphoedema
24 sources
Evidence in one minute
- Common after head and neck cancer treatment (12–75% depending on the definition), worst after surgery plus radiotherapy. Internal lymphoedema (pharynx and larynx) is commoner than external and affects swallowing, mood and QoL — ask about it. Purcell 2013 · Gaitatzis 2026
- Treatment: MLD and light compression, with exercise; CDT is the most consistent approach. Exercise plus MLD with taping or compression helps external, not internal, swelling — low. MLD may suit the head and neck better than limbs because compression is hard to apply. Rajaram 2025 · de-la-Cruz-Fernández L 2025 · Executive Committee of the International Society of Lymphology 2023
- Self-management with skills training and motivational interviewing reduced severity and symptoms v usual care (59-patient pilot) — low; cheap and transferable to SA. Adherence to home care is the main barrier. Deng 2025 · Mullan 2025
- Measurement: the Patterson scale (internal) and LIDS-H&N (external, patient-reported) are the most reliable. Arends 2023
Assessment and treatment
- Assessment: rating scales (Földi, MD Anderson), facial tape landmarks and photography; practice varies widely. Purcell 2013
- Bandaging techniques for the head, breast and genitalia. European Wound Management Association ; senior editorial advisor Moffatt CJ; consultant editors Mortimer P 2005
- Pneumatic devices (Tactile-funded): similar symptom improvement to usual therapist care at 2 months — low; visible swelling and perceived control improved in a wait-list trial — very low. Murphy 2026 · Ridner 2021
- Other: early MLD after oral cancer surgery added little (very low); a photobiomodulation pilot reduced external swelling (unblinded, baseline imbalance — very low); surgery only for selected cases. Tsai 2022 · Deng 2026
Gaps and warnings
- The trials are small pilots, and both device trials were funded by the manufacturer.
For the therapist
- Do: assess internal swelling (swallowing, voice) as well as the face and neck; teach self-management and light compression; use the Patterson scale and LIDS-H&N.
- Stop: routine pneumatic devices without a clear goal (trials manufacturer-funded, low to very low).
- Certainty: low.
For a vascular surgeon in South Africa
- Ask about swallowing and voice as well as facial swelling; a taught self-management programme is the most transferable option where therapists are scarce.
How the evidence points
| High | Mod. | Low | V. low | None | |
|---|---|---|---|---|---|
| Positive | 0 | 0 | 1 | 2 | 0 |
| Null or negative | 0 | 0 | 1 | 0 | 0 |
Sources on this page with a comparison, by the result of their primary outcome and the GRADE certainty of their main finding (Mod. = Moderate, V. low = Very low, None = not graded). Context sources are not counted. How direction is decided.
All 24 sources
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