A case of oral floor carcinoma with upper airway stenosis caused by lymphedema arising after radical surgery

Abstract

This is a case report relating to an oral floor carcinoma with upper airway stenosis caused by lymphedema, which developed after radical surgery involving a neck dissection.A 71-year-old man was referred to our hospital with severe pain in his left oral floor. His lesion was diagnosed as an oral floor carcinoma (cT3N0M0) . A tumor resection, segmental resection of the mandible, and supraomohyoid neck dissection were performed. His jaw was reconstructed with a metal plate, an anterolateral thigh flap, and a tracheostomy. As his postoperative course had been good, we continued with the procedure to remove his tracheal cannula. However, the patient complained of breathing difficulties at the beginning of this process, and this symptom was retained for more than one month. Computed tomography showed airway stenosis caused by severe swelling of the bilateral laryngeal arytenoid. Nasal endoscopic examination also revealed severe swelling of the bilateral laryngeal arytenoid, and salivary retention. This severe swelling was identified as lymphedema and exercise therapy was initiated to decrease it. Two weeks later, his breathing difficulties were observed to have dissipated, and the swelling of the bilateral laryngeal arytenoid was also reduced. Finally, the patient was able to take foods orally and the tracheal cannula was removed.Patients, at times, experience functional difficulties after oral cancer treatment. In such instances, it is important to consider a possible lymphedema as the source of these problems.