Journal
JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY
Volume 64, Issue 9, Pages 1221-1227Publisher
ELSEVIER SCI LTD
DOI: 10.1016/j.bjps.2011.01.006
Keywords
Facial lymphoedema; Lymphaticovenous anastomosis; Supermicrosurgery; Lymphoedema therapy; Head-and-neck reconstruction; ICG; Intra-operative lymphography
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Lymphaticovenous anastomosis (LVA) is a treatment for lymphoedema that can improve lymph circulation by the anastomosis of lymph vessels and veins. A therapeutic effect of LVA for lymphoedema has been shown in limbs, but efficacy for other regions has not been shown. Lymphoedema in the head-and-neck region following cancer resection and radiotherapy is mainly treated with manual lymphatic drainage. However, there is no alternative when this treatment is ineffective because application of compression treatment using a bandage is difficult in this region. We used LVA for lymphoedema in the head-and-neck region and achieved a good outcome. Functional and dilating lymph vessels were identified using pre- and intra-operative fluorescent lymphography, and a lymph vessel with a diameter of about 0.2-1.0 mm was anastomosed with a vein using supermicrosurgery. The outcome of this case suggests that LVA is applicable for treatment of lymphoedema in the head-and-neck region. (C) 2011 Published by Elsevier Ltd on behalf of British Association of Plastic, Reconstructive and Aesthetic Surgeons.
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