Treatment of Radiation-Induced Fibrosis of the Face with Manual Compression Therapy

Abstract

Radiation-induced fibrosis (RJF) is an uncommon complication of radiation therapy. RIF most often occurs in the extremities; it is rare in the head and neck. Only a few medical treatm ents for RIF are available, and they have been mediocre at best. We describ e a case ofRIF of the face that was treated successfu lly with a nonm edical modality: manual compressian therapy.

Retrospective study of the physical therapy modalities applied in head and neck l ymphedema treatment

“…These 2 procedures were also used in combination with ROM mobility and stretching exercises. 7,10,13,14 Exercises used for lymphedema treatment in the present study were in agreement with the literature proposal, based on the lymphatic and venous return of the head and neck region working with the maximum ROM possible of the neck, shoulder girdle, mouth, and facial mimicry. 3,14,25 In a study comprising 11 patients with secondary lymphedema to head and neck surgery, 8 tension pain was observed because of edema (VAS 5 4.4), and, when compared to the pain intensity of the present study (VAS 7.8 6 2.2), the referred pain had a higher score.…”

“…The physical therapy modalities combined in this study showed to be important on pain and lymphedema reduction, because combined lymphatic stimulation, such as manual lymphatic drainage and compressive therapy, reduction of the muscle stiffness as massage and stretching exercises, reduction of the scar adherence and fibrosis, such as pompage and vacuum therapy, improvement of the muscle and joint mobility, such as facial and tongue exercises, and strengthening and ROM exercises of the shoulder and neck region as performed by others. [7][8][9][10][13][14][15] The manual lymphatic drainage techniques applied in patients with head and neck lymphedema should direct the lymph node to intact lymph node pathways, which requires deep knowledge of neck dissection and specific lymphatic pathway examinations. 22,23 Anterior cervical ways have been used in cases where there are no fibroses and scar adherences, as developed in only 3 of the patients in this study, but when there is some obstruction of the physiological drainage, the use of posterior pathways is another possibility.…”

“…Manual lymphatic drainage was performed with gentle, slow, and rhythmic maneuvers, named physiologic manual lymphatic drainage when the cervical anterior pathways were intact, starting on the supraclavicular fossa to stimulate the supraclavicular lymph nodes and moving toward the neck to stimulate the cervical lymph nodes and face. Strategic manual lymphatic drainage was named when the cervical anterior pathways were not intact.…”

Physiotherapy on the Complications of Head and Neck Cancer: Retrospective Study

“…31,32 It may lead to head and neck lymphedema, which can coexist with fibrosis and contribute to tissue hardening, generating different sensations, such as tightness, stiffness, tension, pain and limitation of the neck movements, throat tightness, swallowing disorders, speaking, feeding and breathing. 18,19 The treatment of lymphedema is based on the complex decongestive therapy (CdT) 9,17,18 which includes manual lymphatic drainage, skin care and compressive therapy.…”

Svelgevansker etter strålebehandling

“…Etter vår erfaring kan disse plagene forverres flere år etter avsluttet primaerbehandling og avsluttet rutinekontrollopplegg. Dette bekreftes også i litteraturen hvor det angis at svelgevansker kan oppstå så sent som 20 år etter primaerbehandlingen (3).…”