Background/Objectives: Head and neck lymphedema (HNL) is a common complication after head and neck cancer (HNC) treatment. Reliable and feasible assessment methods are essential for monitoring and management. This study aimed to evaluate the reliability and clinical feasibility of three methods for assessing external HNL in HNC patients: local tissue water (%) using the MoistureMeterD Compact (MMDC), neck circumference using a tape measure, and dermal thickness using B-mode ultrasound.Methods: Thirty-three HNC patients with potential HNL were included. Measurements were performed on the same day, twice by the same rater and once by a different rater. Intraclass correlation coefficients (ICC2,1), (relative) standard error of measurement ((%)SEM), smallest real difference (SRD), systematic differences across measurement occasions, and Bland–Altman plots with 95% limits of agreement were analyzed. Time efficiency and clinical limitations were assessed. As an exploratory analysis, Spearman correlations among methods were examined.Results: All methods demonstrated moderate to very strong reliability (ICCs2,10.781–0.994), except dermal thickness (ICCs2,10.136–0.354). Differences between raters and within one rater were not clinically meaningful. Neck circumference showed the highest reliability (ICCs2,10.958–0.994) and was the fastest to perform with the fewest limitations. The methods showed weak correlations with each other.Conclusions: Neck circumference was the most reliable and time-efficient method assessing HNL in clinical practice but is limited to the neck region. For the head, local tissue water assessment seems the most reliable and feasible. The methods assess different aspects of HNL. Further research should confirm how these methods can complement each another.
背景/目的：头颈部淋巴水肿是头颈癌治疗后常见的并发症。可靠且可行的评估方法对于监测和管理至关重要。本研究旨在评估三种评估头颈癌患者外部头颈部淋巴水肿方法的可靠性和临床可行性：使用MoistureMeterD Compact测量的局部组织水含量（%）、使用卷尺测量的颈围以及使用B型超声测量的皮肤厚度。 方法：纳入33名可能患有头颈部淋巴水肿的头颈癌患者。所有测量在同一天完成，由同一评估者测量两次，并由另一名评估者测量一次。分析了组内相关系数（ICC2,1）、测量（相对）标准误（（%）SEM）、最小真实差异（SRD）、不同测量场合的系统性差异，以及带有95%一致性界限的Bland–Altman图。评估了时间效率和临床局限性。作为探索性分析，还检验了各方法之间的Spearman相关性。 结果：除皮肤厚度测量外（ICCs2,1为0.136–0.354），所有方法均表现出中等至极强的可靠性（ICCs2,1为0.781–0.994）。评估者之间以及同一评估者内部的差异无临床意义。颈围测量显示出最高的可靠性（ICCs2,1为0.958–0.994），且操作最快、局限性最少。各方法之间显示出弱相关性。 结论：在临床实践中，颈围是评估头颈部淋巴水肿最可靠且最省时的方法，但仅限于颈部区域。对于头部，局部组织水含量评估似乎是最可靠且可行的。这些方法评估了头颈部淋巴水肿的不同方面。进一步研究应确认这些方法如何相互补充。
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