Exercise therapy for trismus secondary to head and neck cancer: A systematic review

Kamstra, Jolanda I.; Leeuwen, Marianne van; Roodenburg, Jan; Dijkstra, Pieter U.

doi:10.1002/hed.24366

Cited by 44 publications

(53 citation statements)

References 41 publications

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“…Recently, a systematic review by Kamstra et al [171] identified 12 studies, ranging from chart reviews to randomized controlled trials that analyzed the effect of therapeutic measures on mouth opening after trismus occurred. The duration of the therapy in these studies ranged from 1 to 9 months, the number of exercise sessions per day varied from 2 to 10, with 3 to 8 repetitions, and the duration of stretch ranged from 6 seconds to 60 minutes.…”

Section: Trismusmentioning

confidence: 99%

“…An increase in mouth opening was reported in the majority of studies, although, in many, the final mean mouth opening was still <35 mm suggesting that even after therapy, a proportion of patients still suffer from trismus. No exercise technique was found to be superior to others, and the results were influenced by compliance with the exercises and the time interval between oncologic treatment and the start of the exercises (the sooner, the better) [171]. A recently reported study using the Dynasplint Trismus System confirmed that early detection of trismus and the early start of exercise therapy ensure a better outcome of mouth opening [172].…”

Section: Trismusmentioning

confidence: 99%

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Treatment of late sequelae after radiotherapy for head and neck cancer

Strojan

Hutcheson

Eisbruch

et al. 2017

Cancer Treatment Reviews

254

171

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Radiotherapy (RT) is used to treat approximately 80% of patients with cancer of the head and neck. Despite enormous advances in RT planning and delivery, a significant number of patients will experience radiation-associated toxicities, especially those treated with concurrent systemic agents. Many effective management options are available for acute RT-associated toxicities, but treatment options are much more limited and of variable benefit among patients who develop late sequelae after RT. The adverse impact of developing late tissue damage in irradiated patients may range from bothersome symptoms that negatively affect their quality of life to severe life-threatening complications. In the region of the head and neck, among the most problematic late effects are impaired function of the salivary glands and swallowing apparatus. Other tissues and structures in the region may be at risk, depending mainly on the location of the irradiated tumor relative to the mandible and hearing apparatus. Here, we review the available evidence on the use of different therapeutic strategies to alleviate common late sequelae of RT in head and neck cancer patients, with a focus on the critical assessment of the treatment options for xerostomia, dysphagia, mandibular osteoradionecrosis, trismus, and hearing loss.

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Section: Trismusmentioning

confidence: 99%

Section: Trismusmentioning

confidence: 99%

Treatment of late sequelae after radiotherapy for head and neck cancer

Strojan

Hutcheson

Eisbruch

et al. 2017

Cancer Treatment Reviews

254

171

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“…In order to prevent or to treat trismus, stretching regimens are often prescribed to increase mouth opening 9 . In 2016, a systematic review analyzed the effects of various stretching regimens, but none of them was found to be superior 10 . It has been suggested that early initiation of a therapy for trismus results in a greater improvement in mouth opening 11 .…”

Section: Introductionmentioning

confidence: 99%

Prognostic factors associated with a restricted mouth opening (trismus) in patients with head and neck cancer: Systematic review

et al. 2020

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Background To prescribe early trismus therapy, prognostic factors influencing the restricted mouth opening should be identified first. Our aim is to present an overview of these factors in patients with head and neck cancer. Methods PubMed, Cochrane, EMBASE, and CINAHL were searched using terms related to head and neck cancer and mouth opening. Risk of bias was assessed using the “Quality in Prognosis Studies” tool. A best evidence synthesis was performed. Results Of the identified 1418 studies, 53 were included. Three studies contained a prognostic multivariate model for a restricted mouth opening. Conclusions Patients with head and neck cancer will most likely develop a restricted mouth opening when they have a large tumor near the masticatory muscles that requires extensive cancer treatment. A restricted mouth opening most likely occurs within 6 months after cancer treatment. Further research is necessary on factors related to healing tendency or pain intensity.

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“…Several interventions for this impairment have been described in the literature: application of botulinum toxin, use of medicines, surgical procedures, and direct therapy with the use of commercial devices or through programs with orofacial myofunctional exercises (7)(8)(9)(10)(11)(12)(13)(14) . In addition to possible difficulties associated with cost and access, cancer patients may present limitations to certain types of intervention because of the characteristics of disease evolution and the effects of cancer treatment (2,5,8,9) .…”

Section: Introductionmentioning

confidence: 99%

“…Surgeries aiming to obtain greater mouth opening are more indicated in cases resistant to therapy (9) . The use of commercial devices has proven to be effective (11) , but because of their high cost and, especially, of the evidence of increased mouth opening with conventional exercise programs (10,12) , they would not be suitable for all patients (14) . Muscle exercise programs have not yet proven to be effective as a preventive measure (13) .…”

Section: Introductionmentioning

confidence: 99%

Programa terapêutico fonoaudiológico para abertura de boca em pacientes com câncer de boca e orofaringe em radioterapia adjuvante: estudo piloto

Marrafon

Matos

Simões-Zenari

et al. 2018

CoDAS

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Purpose Assess the effectiveness of an orofacial myofunctional therapeutic program in patients with oral or oropharyngeal cancer submitted to adjuvant radiotherapy through pre- and post-program comparison of maximum mandibular opening. Methods Prospective study involving five adult patients and five elderly patients postoperatively to oral cavity/oropharynx surgery who were awaiting the beginning of radiotherapy or had undergone fewer than five treatment sessions. The study participants had their maximum jaw opening measured using a sliding caliper at the beginning and end of the program. Two mobility exercises and three mandibular traction exercises were selected and weekly monitored presentially for 10 weeks. Descriptive data and pre- and post-therapy comparative measures were statistically analyzed using the Wilcoxon test. Results Ten patients (two women and eight men) with mean age of 58.4 years, median of 57.0 years, completed the therapeutic program. They presented mean maximum mandibular opening of 31.6 ± 11.7 and 36.4 ± 8.0 mm pre- and post-therapy, respectively (p =0.021). Conclusion The proposed orofacial myofunctional therapeutic program increased the maximum jaw opening of patients referred to adjuvant radiotherapy for oral cavity or oropharynx cancer treatment.

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Exercise therapy for trismus secondary to head and neck cancer: A systematic review

Abstract: Changes in mouth opening ranged considerably and no stretching technique was superior to others regarding either prevention or treatment of trismus. Clinical guidelines cannot be given based on this systematic review. © 2016 Wiley Periodicals, Inc. Head Neck 39: 160-169, 2017.

Cited by 44 publications

References 41 publications

Treatment of late sequelae after radiotherapy for head and neck cancer

Treatment of late sequelae after radiotherapy for head and neck cancer

Prognostic factors associated with a restricted mouth opening (trismus) in patients with head and neck cancer: Systematic review

Programa terapêutico fonoaudiológico para abertura de boca em pacientes com câncer de boca e orofaringe em radioterapia adjuvante: estudo piloto

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