Manual Lymphatic Therapy Reduces Internal Lymphedema in Head and Neck Cancer Patients
Description
Cervical lymphedema significantly impairs quality of life, affecting respiration, voice, speech, chewing, and swallowing. Lymphedema may be external or internal, with internal manifesting as soft tissue swelling of the epiglottis, vallecula, pharyngoepiglottic folds, aryepiglottic fold, arytenoids, false vocal folds, true vocal folds and pyriform sinuses. Internal lymphedema can disrupt bolus flow, compromise airway protection, and impair pharyngeal clearance—directly contributing to dysphagia. Despite its impact, no studies have demonstrated the effectiveness of any treatment in reducing internal head and neck lymphedema.
This study aimed to evaluate the effect of manual lymphatic therapy (MLT) on internal lymphedema using data collected from IowaENT center.
Four anatomical structures were analyzed: the epiglottis, arytenoids, false vocal folds, and pyriform sinuses. Independent reviewers assessed video recordings at three time points—pre-treatment (pre), short-term post-treatment (short-term post), and long-term follow-up (long-term post)—using the Revised Patterson Scale to score lymphedema severity. Linear models of mixed-effects for repeated measures were used to evaluate the fixed effect of time on the lymphedema severity scores of the four anatomical structures, while accounting for random effects due to subject and rater. The rater’s effect was included in the model.
A total of 212 observations were collected from 21 head and neck cancer patients. Significant improvements were observed across all four anatomical structures. Our study also showed that the subject-level variability was notable and rater-level variability was minimal.
These findings suggest that manual lymphatic therapy (MLT) may lead to clinically meaningful reductions in internal lymphedema across multiple laryngeal and pharyngeal structures. As a non-invasive and cost-effective intervention, MLT holds promise for improving outcomes in patients with head and neck lymphedema.
Citation Information
Bigelow, Brandon, "Manual Lymphatic Therapy Reduces Internal Lymphedema in Head and Neck Cancer Patients" (2026). Office of Research DMU Research Symposium. 41.
https://digitalcommons.dmu.edu/researchsymposium/2025rs/2025abstracts/41
Manual Lymphatic Therapy Reduces Internal Lymphedema in Head and Neck Cancer Patients
Cervical lymphedema significantly impairs quality of life, affecting respiration, voice, speech, chewing, and swallowing. Lymphedema may be external or internal, with internal manifesting as soft tissue swelling of the epiglottis, vallecula, pharyngoepiglottic folds, aryepiglottic fold, arytenoids, false vocal folds, true vocal folds and pyriform sinuses. Internal lymphedema can disrupt bolus flow, compromise airway protection, and impair pharyngeal clearance—directly contributing to dysphagia. Despite its impact, no studies have demonstrated the effectiveness of any treatment in reducing internal head and neck lymphedema.
This study aimed to evaluate the effect of manual lymphatic therapy (MLT) on internal lymphedema using data collected from IowaENT center.
Four anatomical structures were analyzed: the epiglottis, arytenoids, false vocal folds, and pyriform sinuses. Independent reviewers assessed video recordings at three time points—pre-treatment (pre), short-term post-treatment (short-term post), and long-term follow-up (long-term post)—using the Revised Patterson Scale to score lymphedema severity. Linear models of mixed-effects for repeated measures were used to evaluate the fixed effect of time on the lymphedema severity scores of the four anatomical structures, while accounting for random effects due to subject and rater. The rater’s effect was included in the model.
A total of 212 observations were collected from 21 head and neck cancer patients. Significant improvements were observed across all four anatomical structures. Our study also showed that the subject-level variability was notable and rater-level variability was minimal.
These findings suggest that manual lymphatic therapy (MLT) may lead to clinically meaningful reductions in internal lymphedema across multiple laryngeal and pharyngeal structures. As a non-invasive and cost-effective intervention, MLT holds promise for improving outcomes in patients with head and neck lymphedema.
