Rajaram Rohan, Lee Jenny, Lok Evania, Ng Sally, Yamamoto Takumi
Department of Plastic and Reconstructive Surgery, Austin Health, Heidelberg, Victoria, Australia.
Austin Clinical School, Faculty of Medicine, Dentistry and Health Sciences, the University of Melbourne, Parkville, Victoria, Australia.
Head Neck. 2025 Oct;47(10):2897-2910. doi: 10.1002/hed.28265. Epub 2025 Aug 4.
Head and Neck Lymphoedema (HNL) is debilitating to many domains of patients' structure and function, yet it is the most poorly researched form of lymphoedema. This is due to the variety of signs and symptoms experienced by HNL patients, and this makes it difficult to formulate standardized staging classifications and treatment algorithms. The lymphatic drainage pathway within the head and neck is also highly variable. Currently, there is no gold standard therapy or treatment algorithm for HNL. This leaves many patients with the burden of undergoing suboptimal and unverified treatment to varying degrees of success.
A PRISMA 2020 checklist adherent systematic review was conducted. Medline-OVID was queried with keywords based on HNL and its various management modalities. Title and abstract screening and subsequent full text screening were undertaken by two independent reviewers.
Thirty-seven studies encompassing a sample size of 1452 were discovered from 602 initial results. Overall, the evidence base was weak with many case reports and studies. Complete Decongestive Therapy provided the largest and most consistent data. Surgical methodologies appear to provide significant benefit when cases are selected carefully for appropriateness. Other dermatological and pharmaceutical methods are promising but suffer from a lack of evidence.
The research base on HNL is limited by a lack of standardized severity scale, and the championing of such may encourage higher quality studies to be undertaken.
头颈部淋巴水肿（HNL）会损害患者结构和功能的多个方面，但它却是研究最少的淋巴水肿形式。这是由于HNL患者会出现多种体征和症状，这使得制定标准化的分期分类和治疗算法变得困难。头颈部的淋巴引流途径也高度可变。目前，对于HNL没有金标准疗法或治疗算法。这使得许多患者承受着接受效果各异的次优且未经验证的治疗的负担。
进行了一项遵循PRISMA 2020清单的系统评价。基于HNL及其各种管理方式，使用关键词在Medline - OVID数据库中进行查询。由两名独立的评审人员进行标题和摘要筛选以及随后的全文筛选。
从602个初始结果中发现了37项研究，样本量为1452。总体而言，证据基础薄弱，有许多病例报告和研究。完全减压疗法提供了最大且最一致的数据。当谨慎选择合适的病例时，手术方法似乎能带来显著益处。其他皮肤科和药物治疗方法很有前景，但缺乏证据支持。
关于HNL的研究基础因缺乏标准化的严重程度量表而受到限制，倡导制定此类量表可能会鼓励开展更高质量的研究。
