<< Back to the abstract archive
Leg Lymphaticovenular anastomosis improving facial swelling and cognition
Sonia Kukreja-Pandey, Wei F. Chen
Lymphatic Supermicrosurgery, Dept of Plastic Surgery, Cleveland Clinic, Ohio
2024-01-15
Presenter: Sonia Kukreja- Pandey
Affidavit:
This abstract has not been published or presented before. It is an original compilation of the fellow based on my patients.
Director Name: Wei F. Chen
Author Category: Fellow Plastic Surgery
Presentation Category: Clinical
Abstract Category: General Reconstruction
Introduction:
Primary lymphedema often involves multiple regions and face is an uncommon site of symptoms. Conventional wisdom is to perform lymphatic surgery individually at the affected regions for symptoms resolution. In this article, we share cases of diffuse primary lymphedema with facial involvement who responded to peripheral lymphaticovenular anastomosis (LVA) .
Methods:
Charts of primary lymphedema patients who presented with swelling in multiple limbs and the face and underwent LVA in one limb, were reviewed. Patient history, examination and indocyanine green lymphography(ICGL) were extracted.
Results:
Two female patients met the selection criteria. Patient 1 (37 years) had intermittent swelling and burning pain in all four limbs and a feeling of puffiness of face and gums for 2 years. ICGL confirmed lymphatic insufficiency in all symptomatic regions. As she was clinically and lymphographically worst in left lower extremity (LLE), she underwent LVA in it. Two days later she reported prompt swelling reduction in gums and hands, besides feeling lighter in the LLE and resolution of burning pain. ICGL at 3 and 6 months showed improved ICG transit in all limbs, face ICGL being not repeated.
Patient 2 (62 years) had swelling of three limbs and of cheeks. She underwent LVA in right (symptomatic) leg following which all limbs and the face experienced swelling reduction.
Unexpectedly, both patients noticed that they had longstanding mental fog before which surprisingly cleared after the LVA in leg.
Conclusion:
Face swelling and mental fog can uncommonly be a presentation of primary lymphedema and may resolve with extremity lymphatic surgery.
