Impact of trismus on health-related quality of life and mental health

Johnson, Joakim; Johansson, Mia; Rydén, Anna; Houltz, Erik; Finizia, Caterina

doi:10.1002/hed.23816

Cited by 48 publications

(39 citation statements)

References 25 publications

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“…It was found to be associated with poorer health-related QOL and a greater proportion of HNC patients with trismus displayed depression compared to a control group without trismus [164,167]. Improper mastication mandates changes in food consistency and, in extreme cases, enteral tube feeding.…”

Section: Trismusmentioning

confidence: 99%

Treatment of late sequelae after radiotherapy for head and neck cancer

Strojan

Hutcheson

Eisbruch

et al. 2017

Cancer Treatment Reviews

257

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%

Treatment of late sequelae after radiotherapy for head and neck cancer

Strojan

Hutcheson

Eisbruch

et al. 2017

Cancer Treatment Reviews

257

171

View full text Add to dashboard Cite

show abstract

“…Altered oral function contributes to decreased dietary intake, poor nutritional choices, and impaired systemic health. Speech is impacted by trismus leading to increased social isolation and potentially reduced quality of life and mental health . Another important sequela of trismus is the impaired ability to maintain oral hygiene and receive dental care, leading to increased risk of oral infections and poor response to conservative treatment of osteoradionecrosis .…”

Section: Introductionmentioning

confidence: 99%

“…Speech is impacted by trismus leading to increased social isolation and potentially reduced quality of life and mental health. 10 Another important sequela of trismus is the impaired ability to maintain oral hygiene and receive dental care, 11,12 leading to increased risk of oral infections and poor response to conservative treatment of osteoradionecrosis. 13 Dentists should be part of the multidisciplinary approach to palliative care of the head and neck patient to alleviate pain and prevent infection of the oral cavity.…”

mentioning

confidence: 99%

Prevalence of trismus in patients with head and neck cancer: A systematic review with meta‐analysis

et al. 2019

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Background The purpose of this systematic review and meta‐analysis was to determine the prevalence of trismus in patients with head and neck cancer. Methods Four electronic databases were searched: Cochrane Library, MEDLINE, EMBASE, and Web of Science up to April 2018. Level of evidence was assessed based on Oxford Centre for Evidence‐based Medicine. Publications were restricted to prospective cohort studies (n = 15), randomized clinical trials (n = 3), and cross‐sectional studies (n = 5) reporting on trismus as mouth maximum opening less than or equal to 35 mm in the English language. Results A total of 636 abstracts were reviewed for inclusion. Twenty‐three studies were included in qualitative analysis and 15 studies in meta‐analysis. The results included 2786 patients with head and neck cancer treated with surgery, radiotherapy, and/or chemotherapy either alone or in combination. Based on meta‐analyses, the weighted average prevalence of trismus increased from 17.3% at baseline (95% confidence interval [CI], 10.8%‐26.5%) to a peak of 44.1% at 6 months (95% CI, 36.7%‐51.8%) and decreased to 32.1% at 12 months (95% CI, 27.2%‐37.4%) and continued in average 32.6% at 3‐10 years (95% CI, 22.0%‐45.3%). Conclusions Having a primary site of the oral cavity or oropharynx was associated with a higher risk for developing trismus based on individual studies. Prospective cohort studies or randomized controlled trials with multiple objective trismus measurements, evaluation of disease characteristics, and treatment variables are needed to further investigate the prevalence of trismus secondary to head and neck cancer treatment.

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“…Although not reported as their main finding, their data suggest that mouth‐opening distances correlate with difficulty opening mouth affecting social life (| P r |=.40; median follow‐up=16 months). Several studies confirm that restricted mouth‐opening interferes with QoL and activities of daily living. With respect to the specific impact on private activities, Lee et al.…”

Section: Discussionmentioning

confidence: 93%

Temporal patterns of patient‐reported trismus and associated mouth‐opening distances in radiotherapy for head and neck cancer: A prospective cohort study

Thor

Olsson

et al. 2017

Clinical Otolaryngology

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Mouth-opening distances in patients with HNC post-RT can be understood in terms of associated patient-reported outcomes on trismus-related difficulties. Our data suggest that a reduction in MIO can be expected as patients communicate their mouth-opening status to interfere with private/social life, a clinical warning signal for emerging or worsening trismus as patients are being followed after RT.

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Impact of trismus on health-related quality of life and mental health

Abstract: 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.

Cited by 48 publications

References 25 publications

Treatment of late sequelae after radiotherapy for head and neck cancer

Treatment of late sequelae after radiotherapy for head and neck cancer

Prevalence of trismus in patients with head and neck cancer: A systematic review with meta‐analysis

Temporal patterns of patient‐reported trismus and associated mouth‐opening distances in radiotherapy for head and neck cancer: A prospective cohort study

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