Level 1A: Lymph Nodes for the Head & Neck SLP

The submental lymph nodes are responsible for drainage pathways to the lymphatics of the lower lip, floor of mouth, anterior 1/3 of the tongue & gums! In our patients' who have undergone radiation or surgical repair to the floor of the mouth including free flaps we often see involvement of the neck as well. What does that mean? 

The neck lymphatics are split into two sides: your left and your right. Each of those lymphatics sets a goal to to drain into the deep cervical chain so that it can head towards the venous angle (again left and right). 

In our patient who has undergone neck dissections and treatment pathways with radiation these lymphatics potentially are disrupted forever. Lymphedema of the head & neck can be a debilitating side effect that impacts the ability to speak, eat & breathe. Management of the lymphedema of the head & neck is essential including CDT therapy. What is CDT? Complete Decongestive Therapy. This includes compression garments and wraps. 

Understanding as a therapist where the lymphatics originate and drain will only improve your treatment plan and goals. Submental lymphatics may be disrupted by surgery, radiation treatment or other etiology. However, as a therapist knowing the etiology guides us, leads us into the treatment and provides peace of mind for our patient. 

Submental lymphedema treatment can include over the counter head wraps for as cheap as $37 or if facial lymphedema is present then the use of a custom garment is key for management.