Why is it crucial to raise awareness about lymphedema, especially head and neck lymphedema measurement, and how does a unique cutting-edge technology help in its detection, assessment and monitoring?
- Emma Danciu
- Apr 25
- 5 min read
Lymphedema is a condition causing swelling, usually in the arms or legs, due to a blockage or malfunction in the lymphatic system. The lymphatic system is part of our immune system and helps move lymph fluid (which contains white blood cells, proteins, and waste) throughout our body. When this system isn’t working properly, fluid can build up, causing swelling and discomfort.
It can occur for different reasons, and the timing depends on the case. The common causes are after cancer treatment (especially breast, gynecologic, or prostate cancers): Lymphedema can develop weeks, months, or even years after surgery or radiation, especially if lymph nodes were removed or damaged, after infection or injury: A severe infection or trauma in the affected area can sometimes trigger it relatively quickly, congenital (Primary lymphedema): This form is rare and can appear at birth, during puberty, or later in life due to malformations in the lymphatic system, chronic venous insufficiency or obesity: These can lead to lymphedema developing gradually over time due to pressure on the lymphatic system, and finally, parasites (in some tropical regions): Infections like filariasis can cause it to develop over time after exposure.
Arms and legs being the more common areas where lymphedema happens, it is relevant to raise awareness around head and neck lymphedema (HNL), not just for patients, but also for healthcare providers, caregivers, and the wider community.
Unfortunately, HNL gets under-recognized and under-diagnosed. It often goes unnoticed, especially in its early stages. Many patients and even some clinicians mistake swelling for post-surgical effects or scarring. The lack of awareness delays diagnosis and can lead to more severe, irreversible symptoms.
HNL is a condition characterized by the accumulation of lymphatic fluid in the tissues of the head and neck, leading to swelling and potential functional impairments. It often arises as a complication following treatments for head and neck cancers, such as surgery (removal of lymph nodes or tissues disrupting normal lymphatic drainage and leading to fluid accumulation) and radiation therapy (which can cause scarring and damage to lymphatic vessels, impairing their ability to transport lymph fluid effectively).
As HNL can cause swelling, discomfort, tightness, and pain, but also difficulty breathing, swallowing, or speaking, it greatly affects the patient’s quality of life. These issues can lead to social withdrawal, anxiety, and depression. By talking about HNL more openly, we reduce stigma and encourage patients and doctors to do regular assessment and monitoring, especially for head and neck cancer survivors.
It also helps people prepare for potential risks if they're undergoing head and neck cancer treatments.
Bottom line, HNL is not just a side effect—it’s a chronic, potentially life-altering condition. Raising awareness helps catch it early, treat it more effectively, and improve lives.
Encouraging better training for healthcare providers, including oncologists, ENT specialists, speech-language pathologists and physical therapists, enhances their ability to measure, assess, and dramatically improves diagnosis and management.
Delfin developed the LymphScanner, a cutting-edge instrument
entirely dedicated to measuring and assessing lymphedema
on all parts of the body and in any position.
Because of its ergonomic design and unique features, the LymphScanner is the only instrument on the market capable of effectively and precisely early detect, measure and monitor head and neck lymphedema.
It uses high-frequency, low-power electromagnetic waves to assess localized Percentage of Water (PWC). This technology is called the Tissue Dielectric Constant (TDC), only shaking the water molecules. It is very accurate, with a 2% detection variance, and combined with the water displacement method, it demonstrates twice the sensitivity compared to any other technology.
Lightweight, non-invasive and portable, its software rapidly scans the selected area by applying the probe on the skin surface and gives instant results.
What makes the LymphScanner unique Over Other Methods?
Traditional assessment methods, such as BIS, body tape measurements or palpation, can be subjective and may lack sensitivity, especially in detecting early-stage lymphedema. Advanced imaging techniques, like near-infrared fluorescence imaging, offer detailed insights but may be less accessible and more costly.
BIS is designed for relatively homogeneous, large-volume limbs and is not accurate in the anatomically and electrically complex head and neck region. It relies on detecting changes in extracellular fluid (ECF) through electrical impedance. However, in the head and neck the volume of fluid is smaller, making changes harder to detect and normal variation in tissue conductivity (e.g., due to muscle movement, swallowing, or inflammation) can mask or mimic lymphedema-related changes.
Also, in HNL patients, surgery and radiation therapy can alter tissue properties (fibrosis, scarring, etc.), affecting impedance readings independent of lymphedema. This can result in false positives or false negatives in BIS measurements.
Body tape measurement is considered unreliable for assessing HNL because the head and neck region has irregular contours, soft tissues, and asymmetrical structures (e.g., cheeks, jawline, neck curves). Tape measurements struggle to account for this complexity, leading to inconsistent or inaccurate readings.
Lymphedema in this area often involves mild swelling, making it difficult to detect subtle changes with a tape measure. Even small postural differences, facial expressions, or head positions can skew measurements.
Different clinicians may measure slightly differently in terms of tension on the tape, angle of wrap, and landmark identification. This leads to inter-rater variability and compromises the validity of serial measurements.
Palpation can be a useful initial screening tool, but due to its subjective nature, poor sensitivity for deep or subtle edema, and inability to provide quantitative data, it is unreliable to securely assess or track head and neck lymphedema.
It depends heavily on the clinician’s experience, perception, and technique. And from one clinician to the other, they may feel different things or interpret findings differently.
In the head and neck region, lymphedema can be subtle, especially in early stages, swelling might occur deep in tissues (like around muscles or under the jaw) and may not be easily detectable by touch.
In late-stage lymphedema, tissues may become firm and less elastic, this can feel like normal firmness or scarring, leading to underestimation of fluid-based swelling.
Palpation can’t measure volume or change over time accurately, and there is no numeric data or standardized scale with palpation to track progression or treatment response.
After evaluating the other methods to measure head and neck lymphedema, it can be concluded that the LymphScanner strikes a balance by offering a portable, cost-effective, and extremely reliable solution for early lymphedema detection and assessment, making it particularly valuable in clinical research settings.
The LymphScanner enhances the ability to detect, monitor, and manage head and neck lymphedema effectively, leading to improved patient outcomes and quality of life.
Publications
Wiley
Venchiarutti RL, Templeton S, Mathers L, Charters E, Clark JR.
Treatment approaches and outcomes of a head and neck lymphedema service at an Australian comprehensive cancer center. Head & Neck. 2023; 45(6):1539‐1548. doi:10.1002/hed.27369
Wiley
Pigott B., Brown B., White N., and Al. A prospective observational cohort study examining the development of head and neck lymphedema from the time of diagnosis. Asia-Pac J Clin Oncol. 2023;19:473-481. http://doi.org/10.1111/ajco.13843
Pig
Research Square
Assessing non-invasive imaging devices to detect temperature differentiation and lymphatic/venous flow to the head and neck during head down tilt, supine, and sitting positions The NIID Study (non-invasive imaging device).
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