The incidence of trismus in patients with H&N cancer is non-negligible. Trismus severely impairs HRQL and negatively affects daily life activities in patients with H&N cancer. Further studies regarding symptomatic treatment of patients with trismus are highly warranted. The symptom-specific questionnaire GTQ is useful to identify the problems in this group of patients given it is responsive to showing change over time.

Objective To develop and validate a comprehensive, self-administered questionnaire for patients with limited ability to open the mouth, trismus. Materials and methods We derived the Gothenburg Trismus Questionnaire (GTQ) from empirical evidence in the medical literature and interviews with medical experts as well as patients. The draft version was tested in a pilot study (n=18). Patients with a maximal incisal opening (MIO) of ≤ 35 mm were included. The study comprised patients with benign jaw-related conditions (n=51), patients treated for head and neck (H&N) cancer (n=78) and an age- and gender-matched control group without trismus (n=129). Results The GTQ instrument was well accepted by the patients, with satisfactory compliance and low rates of missing items. After item reduction, due to items not being conceptually relevant and/or low factor loadings, the GTQ demonstrated high internal consistency (Cronbach’s alpha 0.72–0.90), good construct validity and known-group validity. Conclusion We developed a trismus-specific self-administered questionnaire, the GTQ, that showed good psychometric properties. We suggest this questionnaire, that has clear clinical relevance, to be adopted and used in clinical practice and in research, acting as a screening tool as well as an endpoint in intervention and jaw physiotherapy/rehabilitation studies.

The results showed that trismus is associated with a significant impact on HRQOL and that patients with trismus should be approached in a holistic way with respect for the underlying cause, treating not only the physical aspects of trismus but also addressing the patients' mental health.

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