{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T18:25:12Z","timestamp":1786991112417,"version":"build-2736575974"},"reference-count":27,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T00:00:00Z","timestamp":1753833600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T00:00:00Z","timestamp":1753833600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Microsurgery"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Head and neck lymphedema is a common complication of head and neck cancer treatment. Lymphovenous bypass is a promising surgical treatment but may not be an option for all patients after radiotherapy due to the obliteration of local lymphatic targets for bypass. We aim to present vascularized lymph node transfer (VLNT) as a solution to this problem. We report the case of a 38\u2010year\u2010old patient with Stage 2 face and neck lymphedema after treatment for T4aN1oral squamous cell carcinoma, who had no targets for lymphovenous bypass. The patient was treated with a 6 by 14\u2009cm fasciocutaneous VLNT based on the left superficial circumflex iliac artery and vein, to the right facial vein and facial artery. The patient was given a low\u2010dose heparin infusion, placed in a head bolster to prevent neck rotation, and discharged with low\u2010dose aspirin. 4.5\u2009months after free flap reconstruction, the patient underwent revision of the flap including indocyanine green lymphatic mapping, thinning with lymph\u2010sparing liposuction, and re\u2010advancement with Z\u2010plasty for contour. At 11\u2009months, the patient experienced a reduction of swelling, improvement of symptoms, and no further need for compression and manual lymphatic drainage. The area of greatest mobility impairment was resurfaced with flap skin, improving subjective tightness. Indocyanine green imaging at 4\u2009months and 11\u2009months revealed linear lymphatics traversing from the facial skin into the flap. Facial dermal thickness on ultrasound decreased from 1.43 to 1.09\u2009mm between 4 and 11\u2009months postoperatively. Fasciocutaneous VLNT has the potential to restore lymphatic drainage, improving swelling and tightness for patients with head and neck lymphedema who do not have lymphatic targets for bypass. Future studies on head and neck lymphedema should routinely employ ultrasound measurement of dermal thickness as an objective measure.<\/jats:p>","DOI":"10.1002\/micr.70098","type":"journal-article","created":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T11:59:33Z","timestamp":1753876773000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Fasciocutaneous Vascularized Lymph Node Transfer for Head and Neck Lymphedema: A Case Report"],"prefix":"10.1002","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2254-8328","authenticated-orcid":false,"given":"Hamzah","family":"Almadani","sequence":"first","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Jim and Eleanor Randall Department of Surgery Cedars\u2010Sinai Medical Center  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hosung","family":"Rhyu","sequence":"additional","affiliation":[{"name":"New York University College of Dentistry  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Cantor","sequence":"additional","affiliation":[{"name":"Hansjorg Wyss Department of Plastic Surgery at New York University Grossman School of Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip S.","family":"Brazio","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Jim and Eleanor Randall Department of Surgery Cedars\u2010Sinai Medical Center  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,30]]},"reference":[{"issue":"3","key":"e_1_2_7_2_1","first-page":"109","article-title":"Secondary Lymphedema After Head and Neck Cancer Therapy: A Review","volume":"51","author":"Anand A.","year":"2018","journal-title":"Lymphology"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1089\/lrb.2015.0011"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010021\u201085835\u2010w"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.3109\/2000656X.2012.714785"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.23084"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2015.01.005"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2011.03.019"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.27136"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1089\/wound.2012.0405"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2015.10.011"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.25206"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000012945"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.70012"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434\u2010021\u201009887\u2010y"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1089\/lrb.2020.0107"},{"key":"e_1_2_7_17_1","unstructured":"Naoum G. E. M.Wozniack M.Ascha S.Jordan andJ. B.Strauss.2022.\u201cLymphovenous Bypass and Radiotherapy: A Dosimetric Approach to a Multi\u2010Modality Mystery.\u201dhttps:\/\/www.redjournal.org\/action\/showPdf?pii=S0360\u20103016%2822%2901469\u20109."},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/00002060\u2010200201000\u201000003"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10549\u2010022\u201006850\u20107"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520\u2010023\u201007698\u20103"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10549\u2010018\u20104902\u2010z"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0000000000003817"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000010505"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2019.05.024"},{"key":"e_1_2_7_25_1","unstructured":"Vaughan K. S.Crooks J.Locke D.Veigas K.Riches andR.Hilliam.2010.\u201cA Quality of Life Measure for Limb Lymphoedema (LYMQOL).\u201dhttps:\/\/oro.open.ac.uk\/32567\/1\/JoL_Quality_of_Life_Measures.pdf."},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-031-38809-5"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2000.18.8.1652"},{"issue":"3","key":"e_1_2_7_28_1","first-page":"128","article-title":"Validation of the Lymphedema Life Impact Scale (LLIS): A Condition\u2010Specific Measurement Tool for Persons With Lymphedema","volume":"48","author":"Weiss J.","year":"2015","journal-title":"Lymphology"}],"container-title":["Microsurgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/micr.70098","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/micr.70098","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/micr.70098","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T17:27:46Z","timestamp":1786987666000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/micr.70098"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,30]]},"references-count":27,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,9]]}},"alternative-id":["10.1002\/micr.70098"],"URL":"https:\/\/doi.org\/10.1002\/micr.70098","archive":["Portico"],"relation":{},"ISSN":["0738-1085","1098-2752"],"issn-type":[{"value":"0738-1085","type":"print"},{"value":"1098-2752","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,30]]},"assertion":[{"value":"2025-02-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-18","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-30","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70098"}}