Treatment of Head and Neck Cancer-related Lymphedema using Advanced Pneumatic Compression: A Case Study

We present the case of a 70-year-old male who developed lymphedema after chemotherapy and radiation to treat squamous cell carcinoma in the right vocal cord. Soon after the cancer treatment, the patient presented with prominent laryngeal lymphedema, vocal cord paralysis, edematous false and true vocal cords, worsened vocal quality, and prominent stridor at rest. Head and neck lymphedema treatment with the Flexitouch Plus system, an advanced pneumatic compression device (APCD), was prescribed. The Flexitouch Plus prescription was for a once daily H1 treatment, at normal pressure, for 32 minutes. Lymphedema treatment using the APCD was initiated by the patient approximately 2 months after the end of his cancer treatment and lymphedema diagnosis. Three months after the final cancer treatment, and one month following the start of APCD treatment, the patient had a tracheostomy placed due to exhibiting <10-20% typical glottic aperture and recurring shortness of breath. The patient expressed discomfort with the tracheostomy. During the 9-month period after the initiation of APCD treatment, the patient exhibited improvements in several areas, including an increased glottic aperture that was stable at approximately 50-60% of typical, complete management of his lymphedema, as well as increased vocal cord mobility, and a patent airway. These improvements led to the removal of his tracheostomy 8 months after the initiation of APCD treatment. This case highlights the importance of treatment and management of head and neck cancer-induced lymphedema and fibrosis with an APCD