Can you get lymphedema in your throat?

Lymphedema that occurs on the inside of the throat is called internal lymphedema. Patients may experience worsening swallowing difficulties and voice changes 2-6 months after treatment. One study found that up to 90% of patients experience external, internal, or combined lymphedema.2 There may be reports of the throat feeling full or a constant sensation of feeling like something is stuck in the throat. 

Internal swelling can be visualized with the use of endoscopy. The Patterson Edema Scale is a tool that was developed for speech pathologists, radiation oncologists, and ENTs to reliably rate internal lymphedema. 3  This scale allows the provider or clinician to rate the severity of swelling of different structures within the pharynx and larynx. One recent study reports there is a high correlation between subjective patient reported symptoms, objective swallow study findingings, and Patterson Edema Scale Ratings.3 

Patients with greater internal lymphedema will often have more difficulty swallowing and can result in functional swallow changes that impact quality of meal time and increase risk of aspiration and laryngeal penetration. A speech-language pathologist can provide guidance for diet texture recommendations while a dietician can provide assistance with determining what is needed for adequate nutrients. Severe internal swelling may impact the swallow enough that a feeding tube is needed during a patient’s recovery journey. It’s important to note that a radiation oncologist or ENT should rule out other causes for swelling. 

Taylour Campbell, MS CCC-SLP

Sources: 

1 Jackson, L. K., Ridner, S. H., Deng, J., Bartow, C., Mannion, K., Niermann, K., Gilbert, J., Dietrich, M. S., Cmelak, A. J., & Murphy, B. A. (2016). Internal Lymphedema Correlates with Subjective and Objective Measures of Dysphagia in Head and Neck Cancer Patients. Journal of palliative medicine, 19(9), 949–956. https://doi.org/10.1089/jpm.2016.0018

2  Ridner, S. H., Dietrich, M. S., Niermann, K., Cmelak, A., Mannion, K., & Murphy, B. (2016). A Prospective Study of the Lymphedema and Fibrosis Continuum in Patients with Head and Neck Cancer. Lymphatic research and biology, 14(4), 198–205. https://doi.org/10.1089/lrb.2016.0001
3 Starmer, H. M., Drinnan, M., Bhabra, M., Watson, L. J., & Patterson, J. (2021). Development and reliability of the revised Patterson Edema Scale. Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery, 46(4), 752–757. https://doi.org/10.1111/coa.13727