Laryngoscope investigative otolaryngology · 2026
Lymphedema Severity and Quality of Life as a Function of Selective Neck Dissection Technique.
СтатьяНазвание и аннотация: Перевод в очереди
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McLeod Van Wagoner Skylah, MacKay Colin, Taylor S Mark, Corsten Martin, Rigby Matthew
Аннотация
OBJECTIVE: Combined lymphatic and venous insufficiency has been described as a consequence of lymph node dissections, but never in the context of selective neck dissections (SND). The objective of this retrospective cohort study was to compare two methods of SND: one (PEF), which preserves the facial vein (FV) and external jugular vein (EJV), and one (REF), which resects the FV and often the EJV.
METHODS: Head and neck lymphedema was assessed with a modified external lymphedema-fibrosis scale and with the revised Patterson Scale (internal lymphedema). The FACT-HN questionnaire was used to assess quality of life (QoL). Regression modeling was used to determine the effect of the SND technique on lymphedema, controlling for other factors.
RESULTS: A total of 79 patients were included in the analysis, with 60 (75.9%) PEF patients and 19 (24.1%) REF. There were no statistically significant differences in demographics or adjuvant therapy between the two treatment groups. The average score for QoL out of a possible 108 was 94.1 ± 10.4 for PEF and 88.3 ± 11.6 for REF (p = 0.043); regression analysis with covariates showed no significant associations with QoL (p = 0.113). REF patients were observed to have significantly higher external lymphedema scores compared to PEF patients (OR: 2.82, 95% CI: 1.00-8.02; p = 0.049). There were no significant differences in internal lymphedema scores between PEF and REF patients.
CONCLUSION: Results of this study showed resection of the FV and EJV was associated with more severe external lymphedema. A larger study that investigates differences in lymphedema between different SND techniques may therefore be warranted.
LEVEL OF EVIDENCE: 3.
METHODS: Head and neck lymphedema was assessed with a modified external lymphedema-fibrosis scale and with the revised Patterson Scale (internal lymphedema). The FACT-HN questionnaire was used to assess quality of life (QoL). Regression modeling was used to determine the effect of the SND technique on lymphedema, controlling for other factors.
RESULTS: A total of 79 patients were included in the analysis, with 60 (75.9%) PEF patients and 19 (24.1%) REF. There were no statistically significant differences in demographics or adjuvant therapy between the two treatment groups. The average score for QoL out of a possible 108 was 94.1 ± 10.4 for PEF and 88.3 ± 11.6 for REF (p = 0.043); regression analysis with covariates showed no significant associations with QoL (p = 0.113). REF patients were observed to have significantly higher external lymphedema scores compared to PEF patients (OR: 2.82, 95% CI: 1.00-8.02; p = 0.049). There were no significant differences in internal lymphedema scores between PEF and REF patients.
CONCLUSION: Results of this study showed resection of the FV and EJV was associated with more severe external lymphedema. A larger study that investigates differences in lymphedema between different SND techniques may therefore be warranted.
LEVEL OF EVIDENCE: 3.