Areas of expertise:
Roman Skoracki, is the Division Chief for Oncologic Plastic Surgery at the OSUCCC – James. His focus is on reconstruction for cancer patients, particularly microsurgery and surgical treatment for lymphedema. He is one of a small number of surgeons in the country who perform surgical treatments to relieve lymphedema, has developed several surgical techniques in the field and is one of only a few surgeons’ world-wide treating patients for lymphedema of the head and neck. These micro-vascular surgeries treat symptoms of lymphedema by re-routing lymphatic channels to allow proper fluid drainage or re-introducing lymph nodes to the affected region.
He has published more than 60 peer-reviewed manuscripts and three book chapters, along with co-editing the textbook Advanced Therapy of Breast Diseases published in 2012 and a textbook on head and neck reconstruction. He has a keen clinical and research interest in lymphedema, a field he has focused on for the past 10 years of his practice. He is currently engaged in multiple clinical trials as well as basic science projects examining lymphedema and its treatment.
My expertise and experience have prepared me for to make a strong contribution to the proposed study.
Hello I'm a 54 y/o Caucasian male. Have 2 painless reactive lymphnodes in parotid gland for15months 2xnormal size. Core needle biopsy showed no lymphocytes/malignancy. Appeared days after 3rd full Moderna vaccine. Had 2 additional boosters +mild Covid since. Have taken two courses of antibiotics. Still won't shrink. Any ideas?
As per Dr. Skoracki:
Thank you for your inquiry.
We are seeing a number of patients with prolonged lymphadenopathy after COVID vaccinations. Usually these do decrease to a more normal size over time, but this process may take many months (no good data available as to exact duration). Having said all that, I would recommend continued close follow up with a head and neck surgeon for serial physical examinations and likely FU imaging studies and if there is any change other than a decrease in size over time a repeat biopsy.
I think I have a head/neck lymphedema based on my symptom set and much open ended research which led me here. Doctors are unwilling to give credence to my reported symptoms; actively, baselessly resist the possibility of lymphedema. What can I do?
As per Dr. Roman Skoracki:
There are fantastic teams of lymphedema specialists around the country especially those in LE&RN;‘s Centers of Excellence (https://lymphaticnetwork.org/centers-of-excellence) who would be very happy to assess you and design a treatment plan for you.
My sister is suffering from head/neck internal lymphedema, after tongue and lymph node surgery, and radiation seven months ago. She has very little external lymphedema, but a hard neck. Is internal lymphedema harder to treat than external? Are they treated in the same? Are compression and lymphedema pump effective? -Dixie
Posted on behalf of Dr. Skoracki:
The best starting point would be to see a certified lymphedema therapist. The majority of head and neck lymphedema resolves with time. That process can be significantly accelerated with MLD and potentially compression.
The tightness may not be lymphedema, but rather post-surgical and radiation fibrosis. For a definitive diagnosis of internal swelling, an endoscopic examination would be the gold standard.
In terms of lymphedema treatment, there are several options, but the most common surgical options would be lymphovenous bypass and vascularized lymph node transplant, where the latter is more commonly the treatment of choice for isolated internal lymphedema.
Hope this helps.
Thank you for your inquiry
Question (Melissa, ): I was prescribed a lymphatic massage pump for lower body for swelling associated with venous disease and it helps dramatically. A month ago I had gum graft. Still experiencing internal neck swelling - Med catch, smaller bites, feeling of fullness, neck pressure, headaches. No neck imaging yet. I am going to LANA PT in Sept. What imaging should I expect?
As per Dr. Skoracki:
I will defer this question to one of my PT colleagues.
In general, I am not sure there will be any imaging ordered or performed by a lymphedema therapist. You will likely undergo a thorough history and physical examination and develop a treatment plan for your swelling. Your therapist may also recommend that you see additional specialists who may order additional testing.
Our PT added:
I agree, the lymphedema therapist will perform a thorough subjective and objective assessment and develop a treatment plan based on your needs. The lymphedema therapist would not be ordering any imaging but they work closely with the other members of the medical team to assure a comprehensive approach to care.
I was prescribed a lymphatic massage pump for lower body after clotting event, helps dramatically. A month ago I had gum graft. Still experiencing internal neck swelling - Med catch, smaller bites, feeling of fullness, neck pressure, head aches. How long until can say long enough could be lymphatic?
LE&RN; is posting the answer on behalf of Dr. Skoracki. Here is his response:
Thank you for your inquiry. Do you have congenital lymphedema to the lower extremities or leg swelling associated with venous disease?
It would be incredibly rare to develop lymphedema of the head and neck after a gum grafting procedure, unless there is a significant underlying lymphatic defect. Have you had any imaging?
A friend is diagnosed with a Cystic Hygroma, very large, extending from neck to thorax. Specialist said neither surgery nor draining is an option. Looking for names of specialists anywhere who she could contact for help. Worried about her prognosis as she is told she has a very rare case.
Thank you for your inquiry. We do care for complex head and neck as well as thoracic masses, including cystic hygromas. Our usual approach would be a multidisciplinary team approach especially if this is a complex lymphatic (+/- vascular) malformation, including interventional radiologists, head and neck, thoracic and plastic surgeons. I would be happy to review the patients history and imaging to give you a better idea of possible treatment options.
Hope this helps