Effects of manual lymph drainage on lymphoedema and dysphagia in head and neck cancer: a case series

Objective: This study examined whether manual lymph drainage (MLD) administered to head and neck cancer patients with external lymphoedema improved internal lymphoedema, symptoms such as dysphagia and swallowing function. Methods: In this case series, head and neck cancer patients with dysphagia and secondary external lymphoedema on physical examination completed a 4-week, eighttreatment MLD therapy programme. Severity of internal and external lymphoedema, dysphagia and swallowing function were assessed before and after participation in the programme. Results: Of the four participants, two had decreased external lymphoedema severity, three had reduced internal lymphoedema severity, three had a reduction in dysphagia symptoms and two had improvements in flexible endoscopic evaluation of swallowing. There were no changes in functional communication measure scores. Conclusion: Preliminary data suggest MLD has beneficial effects on the symptoms of internal and external lymphoedema. Results further support the association between improved lymphatic function, improved lymphoedema and improved dysphagia and swallowing function. Randomised trials are needed to replicate the findings of this study.