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The diagnosis of head and neck cancer impacts not only appearance but swallowing, vision and motion leading to poor self image and depression. The provision of comprehesive rehabiliation can assist the individual and their families with successful adaptation to liveing with cancer and its complications. The Initial Evaluation Process Evaluation consists of: * Thorough patient history * Skin inspection and palpation of radiated tissues for adherence and fibrosis * Evaluation of the incision for deep and superficial scar tissue * Evaluation of lymphedema severity and consistency of edema * Assessment of mucous membranes and the floor of the mouth * Evaluate muscle strength and ROM (ie: facial nerve or spinal accesory never palsy). * Muscular imbalance CRS Goals of Lymphadema Therapy Intervention: * To improve overall facial appearance and sense of self * Enhance swallowing and articulation * To increase oral intake and reduce dependence upon gastrostomy feeding tubes * To increase range of motion and strength of the head, neck and shoulders * Instruct patients in self management, skin care, and infection identification. * To decrease edema and discomfort prior to radiation Typical Complaints Relating to Lymphedema: * Facial Fullness * Swelling in the submandibular region * Edema that is worse in early morning * Feeling tightness in throat * Difficulty swallowing thicker foods * Swallowing is worse in the morning * Hard "woody" neck * Redeed range of motion and weakness of the neck * Headaches * Stiffness in jaw opening (trismus) * Poor self image and depression CRS Treatment Lymphedema is not the cause of all dysphasia and articulation problems following head and neck cnacer treatment. However, therapy will likely improve the patient's appearance, function and confident participation in social activities. * Swallowing training, positioning and maneuvers * Manual Lymphatic Drainage Therapy * Soft Tissue Mobilization to improve elasticity of radiated areas and scar tissue * Compression therapy utilizing short stretch bandages and the fabrication of custom soft plastic and fabric compression masks. * Exercise-ROM-strengthening, conditioning and activities to normalize neck and shoulder posture. * Connective tissue massage or toher specialized measures. * Patient/caregiver self management |
 
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