Clinical outcomes following complete decongestive therapy for head and facial lymphedema: a retrospective case series

Abstract Background To describe clinical changes observed after standardized complete decongestive therapy (CDT) in patients with head and facial lymphedema (HFL) in a retrospective single-arm case series. Methods Eighteen patients with HFL treated between April 2021 and October 2023 were retrospectively included. All participants underwent standardized CDT. The primary quantitative outcome was subcutaneous percentage water content (PWC), measured using the LymphScanner (Delfin Technologies, Finland) at baseline and post-treatment. Composite hemifacial length, calculated from facial linear distances measured at prespecified anatomical landmarks, was evaluated as an exploratory secondary outcome. Results PWC, the primary quantitative outcome, was lower post-treatment ( P < 0.001). Exploratory composite hemifacial length was also lower post-treatment ( P < 0.001), and the within-patient changes in the two measures were positively correlated ( r = 0.793, P < 0.001). Patient-reported symptoms showed descriptive improvement. The association between longer self-management and less deterioration was exploratory. Conclusions In this small uncontrolled retrospective series composed predominantly of patients with early-stage HFL, lower post-treatment PWC and exploratory composite hemifacial length, together with improvement in patient-reported symptoms, were observed following CDT. These findings cannot establish causality or be generalized to advanced HFL and should be considered preliminary and hypothesis-generating.