Lymphedema of the Head and Neck After Surgery or Radiation (The James)

Lymphedema of the Head and Neck After Surgery or Radiation (The James)

 

Your lymph system helps to get rid of waste products from your cells and helps your body fight infection. If you had surgery to remove some of your lymph nodes (neck dissection) or had radiation treatments to your neck, you may develop swelling called lymphedema (lim-fe-dee`-ma).

Swelling under your chin happens because the lymph nodes in your neck have been removed or changed by treatment and no longer drain like they did before your surgery or radiation. Swelling can also happen on the inside of your neck and affect the mucous membranes of your mouth and throat. Symptoms with this type of swelling may include voice changes, difficulty swallowing or feeling like something is stuck in your throat. More serious cases of swelling inside of the neck can lead to difficulty breathing or vision changes.

After a neck dissection or radiation treatments you may have a collection of fluid under your chin that comes and goes. This is normal and may last for a year before it goes away.

Swelling under your chin may increase if you:

  • Eat fatty foods
  • Eat salty foods
  • Have a cold or the flu
  • Are exposed to heat or extreme cold. Do not use hot tubs or saunas, and limit hot showers to less than 15 minutes. Do not apply a heating pad or ice to the area with swelling.

It is normal to have swelling under your chin when you first wake up in the morning. The fluid can sometimes pool under your chin while you are asleep, but the swelling should lessen when you are upright.

 

What can I do to help drain fluid from areas with swelling?

Here are a few things you can do to help move fluid from the areas of your head and neck that have swelling. These exercises should be done each day.

 

Exercises

 

1.  Deep Diaphragmatic Breathing

  • Take deep breaths so it feels as though you are filling your stomach with air and release slowly.
  • Repeat 3 to 5 times.

 

2. Shoulder Rolls

  • Roll your shoulders forward in a circle.
  • Then, roll your shoulders backwards in a circle. 
  • Relax and repeat 10 times. 

 

3. Head Tilts

  • Gently move your right ear toward your right shoulder, hold for 5 seconds, and then slowly bring your head back to the center. Repeat on the other side.
  • Repeat 5 times to each side

4. Neck Flexion

  • Bend your neck down and look at your toes.
  • Hold for 5 seconds and repeat 10 times. 

5. Neck Extension

  • Bend your head backwards
  • Hold for 5 seconds and repeat 10 times.

  6. Shoulder Abduction

  • Start with your arms down at your side. Lift your arms out to the side and up over your head. 
  • Repeat 10 times. 

7. Shoulder Blade Exercise

  • With your arms bent at the elbows, push your shoulder blades together in back of you. Try not to lift your shoulders up. 
  • Repeat 10 times. 

 

8. Chin Tuck

  • Pull your chin back like you are trying to make a double chin.
  • Hold for 5 seconds. 
  • Relax and repeat 10 times. 

9.  Facial Exercises

Do the movements listed below to make your face muscles tighten. Do these exercises 5 to 7 times each day and hold each exercise 5 to 7 seconds.

  • Smile with teeth showing
  • Smile with mouth closed
  • Yawn
  • Open and close your mouth without causing pain
  • Squeeze your eyes closed
  • Lift your eyebrows 

 

Compression

  • Place your hand on the swollen area and apply gentle pressure for 5 to 10 seconds frequently throughout the day.

 

Posture

  • Keep head and shoulders straight to help any fluid drain.
  • When sleeping, lay on your side without the swelling, if possible.

 

Skin Care

  • Take good care of your skin and teeth to reduce your risk of getting an infection.
  • Use low pH lotion such as Eucerin.
  • Use an electric razor when you shave to reduce nicks/cuts. Clean your razor daily. If you use a disposable razor, throw it away after each use.

 

Lymphedema Clinic

Special clinics to help with lymphedema are located at:

The Stefanie Spielman Comprehensive Breast Center

1145 Olentangy River Road

Columbus, OH 43212

 

OSUCCC - James

460 West 10th Avenue

5th Floor

Columbus, OH 43210

 

The Cancer Support Clinic

Martha Morehouse Medical Plaza Tower

2050 Kenny Road

6th Floor

Columbus, OH 43221

 

The Lymphedema Clinic locations offer the following treatments:

  • Manual Lymphatic Drainage (MLD massage)
    • NOTE: You should only do Manual Lymphatic Drainage massage if you have been instructed by a physical therapist.
  • Skin care
  • Specialized compression bandaging
  • Measurement /fitting of compression garments
  • Patient specific exercises

You will need a doctor’s order for this service. To make an appointment at the Lymphedema Clinic, call (614) 293-0043.
 

 

© May 18, 2022. The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute.

This handout is for informational purposes only. Talk with your doctor or health care team if you have any questions about your care.