Lymphedema of the Head

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Lymphedema of the Head

Postby patoco » Wed Jun 21, 2006 6:19 pm

Lymphedema of the head

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Lymphedema of the head

Lymphedema of the head in clinical practice]

[Article in German]

Ruger K.

Feldbergklinik Dr. Asdonk, St. Blasien/Schwarzwald.

In the Feldberg clinic Dr. Asdonk in St. Blasien we treat primary and secondary lymphedemas of the head with the "Manual lymphdrainage according to Vodder-Asdonk." Secondary lymphedemas are a result of cancer therapy or are caused of tumors or their metastases respectively. A successful therapy is possible at primary lymphedemas of head or lymphedemas following an inflammation or an injury. If the cancer increases unstoppable the so-called "malignant lymphedema" not always decreases. Nevertheless we should treat with manual lymphdrainage therapy because if we do it not the lymphedema increases also unstoppable and it means a disaster for the patient. The manual lymphdrainage therapy is the only treatment we can do. Diuretics are only an indication in the final phase of the malignant lymphedema of the head because they do not take away the protein out of the interstitial tissue and so the edema becomes all the more.

PMID: 8379251 [PubMed - indexed for MEDLINE] ... t=Abstract


Manual lymph drainage as therapy of edema in the head and neck area

[Article in German]

Reiss M, Reiss G.

Klinik fur Hals-Nasen-Ohrenheilkunde, Stadtisches Klinikum Gorlitz.

Depending on its genesis, edema must be treated by medication or diet. Simultaneous application of lymph drainage may be beneficial in some cases, especially in combined edema. The manual lymphdrainage is a special method of massage. In some kinds of edema, in particular lymphedema, only therapeutic lymph drainage introduced into medicine by Vodder, Asdonk and Kuhnke can attain an improvement, since there is no drug which acts on the lymphatic system. We report about primary and secondary lymphedemas of the face and head. Secondary lymphedemas are a result of surgical therapy, cancer therapy, irradiation or are caused of tumors or their metastases respectively. Depending on the state of the edema a lymphatic drainage treatment is indicated palliatively.

PMID: 12621908 [PubMed - indexed for MEDLINE] ... =iconabstr


Selenium in the Treatment of Head and Neck Lymphedema

F. Brunsa,b,f, J. Büntzelc,f, R. Mücked,f, K. Schönekaesf, K. Kisterse,f, O. Mickeb,f

aDepartment of Radiotherapy, Medical School Hannover, Hannover,
bDepartment of Radiotherapy, Münster University Hospital, Münster,
cDepartment of Otolaryngology, Community Hospital Nordhausen, Nordhausen, Department of Radiotherapy, Community Hospital Weiden, Weiden, and Department of Internal Medicine, St. Anna Hospital Herne, Herne, Germany; fGerman Working Group Trace Elements and Electrolytes in Radiation Oncology (AKTE)

Key Words

Sodium selenite
Glutathione peroxidase
Head and neck cancer
Endolaryngeal edema


Objective: To investigate the impact of selenium in the treatment of lymphedema of the head and neck region after radiotherapy alone or in combination with surgery. Subjects and Materials: Between June 1996 and June 2001 a total of 36 cancer patients (29 male, 7 female; median age 61 years) were treated with selenium for persistent, extensive or progressive lymphedema of the head and neck region. Twenty had interstitial endolaryngeal edema associated with stridor and dyspnea. All patients received 350 µg/m2 body surface sodium selenite medication p.o. daily (total dose 50 µg per day) for a period of 4-6 weeks after radiotherapy. The optimal effect of the selenium treatment was assessed after 4 weeks of therapy using the Miller score system. A visual analogue scale on a scale of 0-10 was used to assess the patient's quality of life prior to and after selenium. Results: 75% of the patients had an improvement of the Miller score of one stage or more. The self-assessment of quality of life using the visual analogue scale improved significantly after selenium treatment with a reduction of 4.4 points (p < 0.05). Of the 20 patients with endolaryngeal edema tracheostomy was not necessary in 13 patients (65%), but 5 and 2 received a temporary or permanent tracheostomy, respectively. No episode of erysipelas was observed in all study patients. Conclusion: Our results suggest a short positive effect of sodium selenite on secondary head and neck lymphedema caused by radiotherapy alone or in combination with surgery.

Author Contacts

Dr. Oliver Micke
Klinik und Poliklinik für Strahlentherapie-Radioonkologie
Universitätsklinikum Münster, Albert-Schweitzer-Strasse 33
DE-48129 Münster (Germany)
Tel. +49 251 8347839, Fax +49 251 8347355, E-Mail ... =iconabstr


Indications and risks of manual lymph drainage in head-neck tumors

Preisler VK, Hagen R, Hoppe F.

Klinik und Poliklinik fur Hals-, Nasen- und Ohrenkranke, Universitat Wurzburg.

BACKGROUND: Secondary lymphedema of the head and neck can develop as a result of obstruction of lymphatic channels following the surgical removal of lymph nodes and fibrosis due to irradiation. This can be treated with manual lymphatic drainage. An increase of tumor recurrence due to this therapy is at controversial discussion. PATIENTS: In a retrospective study 191 patients treated for head and neck cancer were questioned on occurrence of lymphedema and therapy with manual lymphatic drainage. RESULTS: 100 patients had received lymphatic drainage, whereas 91 patients belonged to the group without lymphatic drainage therapy. In 37 cases a tumor recurrence or local metastases were reported, 18 of whom had received lymphatic drainage and 19 belonged to the control group. Among these 37 patients neither the group with lymphatic drainage nor the control group differed significantly concerning stage of cancer, histopathological grading, the in sano/non in sano resection of the primary tumor and a lymphangiosis carcinomatosa. An increased recurrence rate among patients who underwent a lymphatic drainage therapy could not be found. CONCLUSION: A lymphatic drainage therapy for patients presenting with lymphedema after the oncological therapy does not increase the rate of local recurrencies. Moreover it improves the quality of life after the cancer therapy. As only few data are available for cases with non in sano surgery and tumors with lymphangiosis carcinomatosa these cases should be excluded from a lymphatic drainage therapy. A spreading of occult tumor cells in these patients might be possible.

PMID: 9592754 [PubMed - indexed for MEDLINE] ... =iconabstr ... ?Doi=78313





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