China Journal of Oral and Maxillofacial Surgery ›› 2026, Vol. 24 ›› Issue (5): 470-476.doi: 10.19438/j.cjoms.2026.05.005

• Original Articles • Previous Articles     Next Articles

Randomized controlled trial of head and neck lymphatic surgery for Alzheimer's disease

Ren Zhenhu1,2, Wang Shiyu1, Li Keyan3, Zhang Xiaochen1, Zhang Zhiyuan1, He Yue1, Li Xia4   

  1. 1. Department of Oromaxillofacial Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Shanghai Research Institute of Stomatology. Shanghai 200011;
    2. Huaihe Hospital of Henan University. Kaifeng 475000, Henan Province;
    3. College of Stomatology, Shanghai Jiao Tong University. Shanghai 200125;
    4. Shanghai Jiao Tong University Mental Health Center, National Center for Mental Disorder. Shanghai 200030, China
  • Received:2026-03-18 Revised:2026-05-15 Online:2026-09-20 Published:2026-10-10

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Abstract: PURPOSE: To investigate the safety and efficacy of cervical shunting to unclog cerebral lymphatic systems surgery (CSULs) in patients with Alzheimer's disease (AD), so as to provide a new reference and alternative for clinical intervention of AD. METHODS: A total of 10 patients diagnosed with AD hospitalized from January to June 2024 at Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine and Shanghai Mental Health Center were enrolled as research subjects. The patients were divided into an experimental group and a control group via the random number table method, with 5 cases in each group. Patients in the experimental group received CSULs combined with routine anti-AD medications, whereas those in the control group continued conventional anti-AD pharmacotherapy and non-surgical conservative management only. Preliminary safety/efficacy were evaluated by comparing intra- and inter-group changes in neuropsychological scale scores from baseline to 3, 6, 12 and 18 months. RESULTS: Statistical analysis of scale scores demonstrated that disease progression was arrested in 3 patients of the experimental group without progressive deterioration relative to baseline, while cognitive impairment continued to deteriorate in the remaining 2 cases. In the control group, only 1 patient maintained stable baseline status, and progressive dementia was observed in the other 4 patients. No perioperative or long-term postoperative adverse events such as surgical site hemorrhage or surgical infection were recorded among all patients in the experimental group during regular follow-up. CONCLUSIONS: Compared with conventional medication-only conservative therapy, CSULs present favorable safety and preliminary efficacy in slowing AD progression, indicating promising potential as an innovative breakthrough for surgical intervention of AD. Given the limited sample size of the present trial, further large-sample clinical investigations are required to verify the therapeutic effect of this surgical technique.

Key words: Head and neck lymphatic surgery, Cervical shunting to unclog cerebral lymphatic systems surgery, Alzheimer's disease

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