Response from Dr. Skoracki:

Not unless there was widespread lymph node involvement with cancer prior to the radioactive iodine treatment. In that case other surgery would usually be indicated and radioactive iodine alone would not likely be the only therapy. Short answer – I have never seen lymphedema of the head and neck develop after radioactive iodine treatment alone.

Hope that helps

Dr. Skoracki’s response:

The eyelid issues are unrelated. The drainage from the head and neck is to a different set of lymph nodes. Having said that, depending on the systemic treatment of the breast cancer, this can have effects on other parts of the body including generalized swelling. If that is the case, your medical oncologist will want to know.

Dr. Skoracki’s response:

The answer is yes. Our group does perform LVB and VLNT for head and neck lymphedema.

As per Dr. Skoracki:

The eyelids are designed to respond to even minor trauma with significant swelling. Thankfully this will settle in the absence of further irritation within days to weeks, unless it is irritated again.
I am not aware of isolated prolonged lymphedema isolated to the eyelids alone, this is usually in combination with a lymphatic disruption in the neck and/or lower face that involves the lower face and may include the eyelids as well.
I am not sure of anyone else who sees or treats a significant number of head and neck lymphedema patients beyond our center in the US.

Thanks,
Roman

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.

-Dr. Skoracki

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.

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

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.

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?

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