Facial Lymphedema Following Head and Neck Tumor Resection: Preliminary Experience of Supermicrosurgical Treatment With LVA-Report of Three Cases

Microsurgery. 2025 Jan;45(1):e70012. doi: 10.1002/micr.70012.

Abstract

Facial lymphedema (FL) is a potential complication following head-and-neck tumor (HNT) therapy. Conservative management is often difficult, and there is limited literature on surgical treatments for FL. This report presents three cases of FL treated with lymphaticovenular anastomosis (LVA). All three patients were male with ISL stage 2 FL following treatment for oral squamous cell carcinoma, aged 59, 45, and 55 years. In each case, double end-to-end LVAs were performed in the preauricular region (right side in cases 1 and 3, left side in case 2). Follow-up was 12 months for cases 1 and 2 and 9 months in case 3, with no post-operative complications. Case 1 showed a 4% reduction in two of three anthropometric parameters, case 2 demonstrated an 8% reduction in all the parameters along with quality-of-life improvement, and case 3 had a 6% reduction in all parameters with improvement in both pinch test and quality-of-life. LVA supermicrosurgery appears to be an effective treatment for FL, improving quality of life with minimal complications and no need for further surgical interventions.

Keywords: LVA; eyelid lymphedema; facial lymphedema; head and neck tumor; super‐microsurgery.

Publication types

  • Case Reports

MeSH terms

  • Anastomosis, Surgical* / adverse effects
  • Anastomosis, Surgical* / methods
  • Carcinoma, Squamous Cell / surgery
  • Face / surgery
  • Head and Neck Neoplasms / surgery
  • Humans
  • Lymphatic Vessels / surgery
  • Lymphedema* / etiology
  • Lymphedema* / surgery
  • Male
  • Microsurgery* / methods
  • Middle Aged
  • Mouth Neoplasms / surgery
  • Postoperative Complications / etiology
  • Postoperative Complications / surgery
  • Quality of Life