Amanda Purcell Head and neck lymphoedema management practices

Head and neck lymphoedema (HNL) can be classified as primary or secondary. Primary HNL is caused by congenital impairment of the lymphatic system and is rare. Secondary HNL commonly develops as a result of acquired damage to the lymphatic system during treatment for head and neck cancer or blockage by the cancer itself (Thoma, 2012). Surgery and radiotherapy are the two primary modalities used to treat head and neck cancer and both can precipitate the development of HNL. HNL is most common following head and neck cancer surgery, but is most severe after treatment with combined surgery and radiotherapy (Micke et al, 2003; Lewin et al, 2010). The prevalence of HNL is difficult to quantify, but in comparison to other types of lymphoedema, it is less common (Smith and Lewin, 2010). Reported HNL rates range from 12.1% (Chen et al, 2010) to 48% (Büntzel et al, 2007), to 75.3% (Deng et al, 2012) of samples of head and neck cancer patients. Such variation arises from the use Assessment There is no gold standard test available to diagnose HNL (Deng et al, 2011), but a wide range of assessment tools are used to measure and monitor the condition. The complexities of the head and neck region make assessment challenging. Depending on the assessment used and the area examined, evaluation of lymphoedema can vary substantially.