Objective
Head and neck lymphedema usually occurs in the patients with head and neck cancer receiving neck dissection and radiotherapy. The incidence rate is 15%~54%. The common presentations are heaviness or tightness in head and neck initially, progressing to head and neck edema, or imparing speaking, swallowing, breathing, or vision in more severe cases. Lymphovenous anastomosis (LVA) is an accepted method to treat extremity lymphedema. Herein we reported three cases using LVA to treat head and neck lymphedema and a literature review was also conducted.

Material and Methods
In 2021, three patients with head and neck lymphedema received LVA. One patient suffered from right facial lymphedema after receiving partial glossectomy and neck dissection. Another two patients suffered from laryngeal edema after radiation therapy for lymphoma and oropharyngeal cancer, respectively. Via preauricular incision, one to three LVAs were performed for each case. Postoperative follow-ups were done with length measurement for specific landmarks, laryngoscopy, or subjective evaluations. A literature search was performed in the PubMed and Google Scholar using “head and neck lymphedema” and “lymphovenous anastomosis” as keywords. Only human studies were taken into consideration.
Results
All the three patients’ head and neck lymphedema improved postoperatively from either subjective or objective perspective. Literature review also found that a total of three articles including six patients showed improvement for head and neck lymphedema after LVA.

Conclusions
Based on our preliminary result and literature review, LVA might be a minimally invasive procedure for relieving head and neck lymphedema.