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Assessing Head and Neck Cancer-Related Lymphoedema Using Indocyanine Green Lymphography-A Pilot Study.

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Summary

Head and neck lymphoedema (HNL) significantly impacts quality of life. Indocyanine Green Lymphography (ICG-L) revealed altered lymphatic drainage in HNL patients, highlighting the need for improved management strategies.

Keywords:
head and neck cancerindocyanine green lymphographylymphoedemapatient‐reported outcomesphysical assessmentsquality of life

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Area of Science:

  • Oncology
  • Lymphedema Research
  • Medical Imaging

Background:

  • Head and neck cancer treatments frequently lead to head and neck lymphoedema (HNL).
  • HNL significantly diminishes patients' quality of life (QoL).
  • Understanding lymphatic drainage alterations is crucial for managing HNL.

Purpose of the Study:

  • To investigate lymphatic drainage changes in HNL patients using Indocyanine Green Lymphography (ICG-L).
  • To evaluate the impact of HNL on QoL, physical, and functional outcomes.
  • To correlate ICG-L findings with clinical and bioimpedance assessments.

Main Methods:

  • Twenty individuals with HNL and 10 healthy controls participated.
  • Data collection included ICG-L, Lymphedema Symptom Intensity and Distress survey, bioimpedance spectroscopy (BIS), and skin assessments.
  • Statistical analysis employed non-parametric and Kruskal-Wallis tests.

Main Results:

  • ICG-L demonstrated preserved lymphatic drainage in non-surgical/unilateral cases, but disrupted pathways with compensatory drainage in bilateral cases.
  • HNL patients reported significantly higher symptom scores (soft tissue, neurological, biobehavioral).
  • Significant differences were noted in lymphatic dysfunction, skeletal muscle mass, and phase angle (BIS).

Conclusions:

  • HNL presents a substantial symptom burden and altered lymphatic drainage.
  • ICG-L offers valuable insights into lymphatic dysfunction in HNL.
  • Findings suggest potential for refining HNL management strategies using ICG-L.