Abstract
Lipofilling is a new treatment option for head- and neck cancer patients who suffer from chronic and severe (chemo-) radiation or surgery-related swallowing problems. Lipofilling is a technique of autologous grafting in which living fat cells are transplanted from one location to another in the same patient. In the case of head and neck cancer patients, volume loss or muscle atrophy of the tongue or pharyngeal musculature caused by the treatment may result in oropharyngeal dysfunction. Firstly, intensive swallowing therapy will be given, but if that offers no further improvement and the functional problems persist, lipofilling can be considered. By transplantation of autologous adipose tissue, the functional outcomes might improve by compensating the existing tissue defects or tissue loss. Only a few studies have been published which evaluated the effectiveness of this new treatment option. The results of those studies show that the lipofilling technique seems safe and of potential value for improving swallowing function in some of the included patients with chronic and severe dysphagia after surgery and/or (chemo-) radiation therapy for head and neck cancer. The lipofilling procedure will be described in detail as well as the clinical implications.
Highlights
Head and Neck Cancer (HNC) is the seventh most common type of cancer worldwide [1]
Patients might benefit from lipofilling when part of the etiology of the dysphagia consists of lack of volume, for instance, of the tongue or pharyngeal wall
Before considering if lipofilling is suitable for a patient, it is recommended to perform objective assessments such as Fiberoptic Endoscopic Evaluation of Swallowing (FEES) or a Video Fluoroscopic Swallow Study (VFSS) and a Magnetic Resonance Imaging (MRI) assessment
Summary
Head and Neck Cancer (HNC) is the seventh most common type of cancer worldwide [1]. The regions of HNC include cancers of the nasal cavity, oral cavity, nasopharynx, oropharynx, hypopharynx, larynx, and paranasal sinuses (see Figure 1). This classification is based on the anatomic tumor extent and includes three different aspects. The size of the primary tumor (T), secondly the presence or absence and extent of involved regional lymph nodes (N), and lastly the presence or absence of distant metastasis (M). With the TNM classification, it is possible to give an estimate on cancer prognosis and it is helpful for treatment selection and proper communication. An example of a TNM classified advanced oropharynx carcinoma with one lymph node involved and diagnosed with no distant metastasis is T3N1M0. An example of a TNM classified advanced oropharynx carcinoma with one lymph node involved and diagnosed with no distant metastasis is T3N1M0. 1.2 Head and neck cancer treatment
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