通过淋巴手术治疗四肢淋巴水肿已取得了巨大进展。然而，包括头部和颈部在内的其他区域的淋巴水肿仍然被忽视。最近对大脑淋巴系统以及颅内和颅旁淋巴系统之间通讯的发现引起了人们对头颈淋巴管的关注。头颈部淋巴水肿可能是由于淋巴系统的固有异常（原发性）或意外或医源性淋巴管损伤（继发性）引起的。头部和颈部含有大量的淋巴组织网络。它们可能受到直接肿瘤浸润、肿瘤和周围癌组织的手术切除和/或放射治疗的影响。在面部美容手术前对患者进行适当的筛查和咨询可以避免处理术后淋巴水肿的痛苦。头颈部淋巴水肿 (HNL) 的进展可导致慢性炎症、纤维硬化和纤维脂肪沉积，导致永久性畸形和残疾。患者可能会出现功能障碍，包括皮肤变化、疼痛、运动范围受限、挛缩、吞咽困难、构音困难、呼吸困难和牙关紧闭，所有这些都会导致生活质量下降。尽管存在这些已知的缺陷，但由于缺乏对这一实体的认识以及可用于测量内部或外部肿胀的工具，HNL 的诊断不足。作者的文章全面回顾了当前的诊断方法和管理策略以及未来的前景。版权所有 © 2024，医学博士 Mutaz B. Habal。

Great advancements have been made in the management of lymphedema of the extremities with lymphatic surgery. However, lymphedema of other regions, including head and neck, has remained neglected. Recent discovery of lymphatic system in the brain and the communication between intracranial and paracranial lymphatic systems has drawn attention to the head and neck lymphatics. Lymphedema of the head and neck region can result from inherent abnormality of the lymphatic system (primary) or be caused by accidental or iatrogenic injury to lymphatics (secondary). The head and neck contain a large network of lymphatic tissue. They may be affected by direct tumor infiltration, surgical resection of tumors and surrounding cancer tissue, and/or radiotherapy. Proper screening and counseling of patients before facial aesthetic procedures may avoid managing the distress of lymphedema postprocedure. Progression of head and neck lymphedema (HNL) can lead to chronic inflammatory, fibrosclerotic, and fibrofatty deposition, resulting in permanent deformity and disability. Patients may experience functional impairment, including skin changes, pain, range of motion limitations, contracture, dysphagia, dysarthria, dyspnea, and trismus, all leading to reduced quality of life. Despite these known disabilities, HNL is underdiagnosed due to a lack of awareness about this entity and of tools available for measuring internal or external swelling. The authors' article comprehensively reviews the current diagnostic methods and management strategies and what lies ahead.Copyright © 2024 by Mutaz B. Habal, MD.