Negative pressure treatment benefits patients with head and neck cancer symptoms

Until recently, there have been few treatment options to support healing in patients who have had head and neck cancer. Scarring, fibrosis, movement restriction and swelling can all cause difficulties with swallowing and breathing, so finding treatments that help these symptoms heal is critical. LymphaTouch® is a gentle tool that can help treat many of the symptoms these patients live with. The device is unique in the way it creates negative pressure (suction) over the tissues and stretches them vertically. Negative pressure treatment with LymphaTouch® gives therapists a range of options that can significantly improve their outcomes.

Treatment options include

• Lymphedema
• Fibrosis from radiation and lymphedema
• Soft tissue restrictions
• Scar restrictions

Lymphedema

LymphaTouch® mimics manual lymph drainage: it generates negative pressure in the tissues and opens the lymphatic capillaries at the same time. It does this by lifting the skin and interstitial tissues in a pulsating rhythm, which creates ideal conditions for effective lymph drainage. Simply guide the treatment cup along the chosen lymphatic pathway and adjust the negative pressure until the skin moves appropriately. Over the neck, LymphaTouch® reaches deep swelling that restricts movement, breathing and swallowing.

Fibrosis from radiation and lymphedema

LymphaTouch has several settings that help break up fibrosis.

On the rhythmic pulsating setting, the device applies negative pressure to hardened tissues, allowing them to stretch and expand.

A small change in settings lets you hold the negative pressure continuously, so tissues can be lifted and stretched over a sustained period. The smaller treatment cups allow vertical stretching behind the ear and on delicate areas of the face.

The continuous hold setting is similar to cupping, but with LymphaTouch® we can control the amount of negative pressure for patient comfort (20 to 250 mmHg) and stop the suction at any time. Cupping also creates negative pressure, but cups left on the skin can cause circular bruising (ecchymosis). Using LymphaTouch® avoids this and protects tissues that are already fragile.

Mechanical high-frequency vibration can be used with either the pulsating or the continuous hold setting. The vibration helps break up radiation and lymphedema fibrosis by shaking the treated area. By adjusting the vibration frequency, we can loosen deep fibrotic areas that we would normally not be able to reach. This is especially useful under the chin and around the larynx, where fibrosis tends to be stubborn.

Soft tissue restrictions

Surgical scars and radiation in the head and neck area can restrict movement, swallowing, speaking and breathing. Negative pressure on the continuous hold setting, combined with regular rehabilitation, can significantly help relieve these symptoms.

Used over the temporomandibular joint (TMJ), the device can stretch the tissues in the joint and ease movement. Myofascial stretching can be enhanced by placing the treatment cup over stiff areas of the face and neck. The same technique can be used over the larynx and hyoid to loosen restrictions that affect swallowing. LymphaTouch® can also release restrictions in and around the diaphragm by reaching its deep tissues.

Twisting or pulling the treatment cup horizontally can increase the effect of the stretch.

Scar and graft-site restrictions

Lifting scars with negative pressure can also release adhesions that restrict tissue movement and lymph flow. On the pulsating or continuous hold setting, LymphaTouch® vertically lifts the subcutaneous scar tissue that forms adhesions.

Written by Kathy McGinthy, physiotherapist and lymphatherapist at Johns Hopkins Hospital.