The Management of Head and Neck Lymphoedema: A 2025 Systematic Review.

[BACKGROUND] Head and Neck Lymphoedema (HNL) is debilitating to many domains of patients' structure and function, yet it is the most poorly researched form of lymphoedema. This is due to the variety of signs and symptoms experienced by HNL patients, and this makes it difficult to formulate standardized staging classifications and treatment algorithms. The lymphatic drainage pathway within the head and neck is also highly variable. Currently, there is no gold standard therapy or treatment algorithm for HNL. This leaves many patients with the burden of undergoing suboptimal and unverified treatment to varying degrees of success.

[METHODS] A PRISMA 2020 checklist adherent systematic review was conducted. Medline-OVID was queried with keywords based on HNL and its various management modalities. Title and abstract screening and subsequent full text screening were undertaken by two independent reviewers.

[RESULTS] Thirty-seven studies encompassing a sample size of 1452 were discovered from 602 initial results. Overall, the evidence base was weak with many case reports and studies. Complete Decongestive Therapy provided the largest and most consistent data. Surgical methodologies appear to provide significant benefit when cases are selected carefully for appropriateness. Other dermatological and pharmaceutical methods are promising but suffer from a lack of evidence.

[CONCLUSION] The research base on HNL is limited by a lack of standardized severity scale, and the championing of such may encourage higher quality studies to be undertaken.