Cutaneous lymphatics and chronic lymphedema of the head and neck

Feely, Meghan; Olsen, Kerry D.; Gamble, Gail L.; Davis, Mark D.P.; Pittelkow, Mark R.

doi:10.1002/ca.22009

Cited by 11 publications

(4 citation statements)

References 74 publications

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“…27 While radiation therapy alone has been identified as a significant factor in the development of lymphedema, neck dissection compounds the problem by further disrupting lymphatic channels and venous drainage. 27,28 Because cutaneous lymphatic channels of the head and neck tend to drain vertically, we believe that the larger the horizontal aspect of the skin incision, the more likely is clinically significant lymphedema postoperatively (see Feely et al 29 for an excellent review of cutaneous lymphatics of the head and neck). In their recent series of their RANDs through a modified facelift incision, Kim et al 10 allude to improved lymphedema scores among these patients as compared to standard neck dissection, which are to be published in a later manuscript.…”

Section: Discussionmentioning

confidence: 99%

Robot-Assisted Neck Dissection Through a Modified Facelift Incision

Albergotti

Byrd

Nance

et al. 2015

Ann Otol Rhinol Laryngol

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Section: Discussionmentioning

confidence: 99%

Robot-Assisted Neck Dissection Through a Modified Facelift Incision

Albergotti

Byrd

Nance

et al. 2015

Ann Otol Rhinol Laryngol

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“…The lower extremities are involved in most cases. In contrast, cervical lymphedema is uncommon and most often seen in patients with neck surgery, head and neck cancer, thrombosis of the jugular and subclavian veins, or right heart failure . There are few reports of cervical lymphedema not associated with these conditions …”

mentioning

confidence: 99%

Lymph Vessel Thrombus Detection in Cervical Lymphedema: A Case Series

Kunze

Staritz

2017

J of Ultrasound Medicine

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Although thrombosis in the terminal part of thoracic duct has been described in patients with head and neck cancer and upper vein thrombosis, normally medical imaging is not successful in depicting such lymphatic thrombosis. This case series is about three patients with acute onset of cervical lymphedema following minor trauma or exceptional physical strain. Using high-resolution ultrasound, it was possible to detect a thrombus formation in the terminal parts of the thoracic duct or the lymph duct. Within a few weeks all patients recovered without relapse for several years.

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“…The injected hUCMSCs are unlikely to migrate from the conjunctiva to the submandibular lymph nodes. However, the lymphocytes in the eyelids are drained into the preauricular node, parotid, or submandibular nodes [ 32 ]. The lymphocytes in the conjunctiva might be regulated by hUCMSCs and return to the cervical lymph nodes.…”

Section: Discussionmentioning

confidence: 99%

Subconjunctival injection of human umbilical cord mesenchymal stem cells alleviates experimental allergic conjunctivitis via regulating T cell response

Li,

Ou,

Shen

et al. 2023

Stem Cell Res Ther

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Background T helper 2 (Th2) cells are thought to play critical roles in allergic conjunctivitis (AC). They release inflammatory cytokines to promote an allergic response in AC. Due to individual heterogeneity and long-term chronic management, current therapies do not always effectively control AC. Mesenchymal stem cells (MSCs) have been shown to be effective in treating allergy-related disorders, but it is unclear how exactly the Th2-mediated allergic response is attenuated. This study aims to elucidate the therapeutic effect and mechanism of the human umbilical cord MSCs (hUCMSCs) in a mouse model of experimental AC (EAC). Methods A mouse EAC model was established by inoculating short ragweed (SRW) pollen. After the SRW pollen challenge, the mice received a single subconjunctival or tail vein injection of 2 × 106 hUCMSCs, or subconjunctival injection of hUCMSCs conditioned medium (hUCMSC-CM), and dexamethasone eye drops was used as positive control; subsequent scratching behavior and clinical symptoms were assessed. Immunostaining and flow cytometry were carried out to show allergic reactions and the activation of CD4 + T cell subsets in the conjunctiva and cervical lymph nodes (CLNs). Gene expression was determined by RNA-seq and further verified by qRT-PCR and Western blot. Co-culture assays were performed to explore the regulatory role of hUCMSCs in the differentiation of CD4 + naive T cells (Th0) into Th2 cells. Results Subconjunctival administration of hUCMSCs resulted in fewer instances of scratching and lower inflammation scores in EAC mice compared to the tail vein delivery, hUCMSC-CM and control groups. Subconjunctival administration of hUCMSCs reduced the number of activated mast cells and infiltrated eosinophils in the conjunctiva, as well as decreased the number of Th2 cells in CLNs. After pretreatment with EAC mouse serum in vitro to mimic the in vivo milieu, hUCMSCs were able to inhibit the differentiation of Th0 into Th2 cells. Further evidence demonstrated that repression of Th2 cell differentiation by hUCMSCs is mediated by CRISPLD2 through downregulation of STAT6 phosphorylation. Additionally, hUMCSCs were able to promote the differentiation of Th0 cells into regulatory T cells in CLNs of EAC mice. Conclusions Subconjunctival injection of hUCMSCs suppressed the Th2-allergic response and alleviated clinical symptoms. This study provides not only a potential therapeutic target for the treatment of AC but also other T cell-mediated diseases.

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Cutaneous lymphatics and chronic lymphedema of the head and neck

Cited by 11 publications

References 74 publications

Robot-Assisted Neck Dissection Through a Modified Facelift Incision

Robot-Assisted Neck Dissection Through a Modified Facelift Incision

Lymph Vessel Thrombus Detection in Cervical Lymphedema: A Case Series

Subconjunctival injection of human umbilical cord mesenchymal stem cells alleviates experimental allergic conjunctivitis via regulating T cell response

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