Mouth opening and trismus in patients undergoing curative treatment for head and neck cancer

Steiner, Frederica; Evans, John M.; Marsh, Reginald; Rigby, Paul; James, S.; Sutherland, Kirsty; Wickens, Robin; Nedev, Nikolay; Kelly, Barbara A.; Tan, Swee T.

doi:10.1016/j.ijom.2014.12.009

Cited by 42 publications

(65 citation statements)

References 24 publications

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“…The absence of specific criteria for the definition of trismus and the non-homogeneous group of patients in the different studies are also some of the main reasons for the above wide variation of the prevalence of trismus in head and neck cancer patients [6,9,12,13].…”

Section: Discussion Trismusmentioning

confidence: 99%

“…Surgery combined with radiotherapy or chemoradiotherapy were related with reduced MMO. However, the number of patients with oral cancer, who received post-operative RT or chemoRT, was not reported [13]. In a prospective study of a homogeneous group of 143 patients with oral cancer, the prevalence of Trismus at the end of therapy was 44%.…”

Section: Discussion Trismusmentioning

confidence: 99%

“…Trismus was an independent and important risk factor for the worsening of quality of life in the several studies and the need for support of oral structures to prevent or manage trismus was highlighted [6,12,13,27,28]. Exercises and specific prevention programs for trismus were prospectively studied but the beneficial result was not permanent for all patients [29−32].…”

Section: Eortc Qlq Head/neck35mentioning

confidence: 99%

“…The risk for trismus is also increased when the masticator and lateral pterygoid muscles are included in the radiation field, in patients with advanced stage of disease, and with chemoradiotherapy [6,9−11]. Furthermore, patients with oral carcinoma, who receive post-operative radiotherapy have increased risk for trismus, which is related to the fibrosis of masticator muscles due to radiotherapy and due to fibrosis related to the surgical management of tumour [10,12,13].…”

Section: Introductionmentioning

confidence: 99%

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Trismus and reduced quality of life in patients with oral squamous cell carcinoma, who received post-operative radiotherapy alone or combined with chemotherapy

Galitis

Droukas

Tzakis

et al. 2017

Forum of Clinical Oncology

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Background Patients, who receive radiotherapy (RT) for head and neck cancer, develop chronic functional abnormalities and survive with reduced quality of life. Purpose We aimed to study patients with oral cancer, who received post-operative radiotherapy or chemoradiotherapy. Patients Ten patients (mean age 63.8 years) were included. Methods Oral mucositis, pain and xerostomia, maximum mouth opening (MMO) and functional abnormalities before and after RT were recorded. The 35 mm MMO or less was accepted as trismus. Patients completed the EORTC QLQ C-30 and Head/Neck35 questionnaires. Results Mean RT dose was 64.3 Gray. Six patients received chemoradiotherapy. Severe mucositis, pain and xerostomia were recorded in 6 and 5 patients respectively. MMO was reduced in all patients. The mean MMO (34 mm) reached the level of trismus. The total number of symptoms increased from 3.1 to 6.3 in C-30 and from 3.1 to 8.8 per patient in the H/N35. Severe fatigue, pain, limitations at work, weakness, sad feelings, family problems, sleeping problems, anorexia, financial difficulties, tense/irritable, constipation, nausea, vomiting and depression were most often reported with C-30. Most patients reported low to moderate quality of life. Severe oral, jaw and neck pain, swallowing problems, taste alterations, sticky saliva, dry mouth, coarseness, dental problems, feeling sick and reduced interest in life/sex were the most common symptoms reported with N/H35. Conclusions The observed trismus, 2- to 3-fold increase of symptoms and poorer quality of life highlighted the need for support of oral cancer patients, who receive postoperative radiotherapy or chemoradiotherapy.

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Section: Discussion Trismusmentioning

confidence: 99%

Section: Discussion Trismusmentioning

confidence: 99%

Section: Eortc Qlq Head/neck35mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Trismus and reduced quality of life in patients with oral squamous cell carcinoma, who received post-operative radiotherapy alone or combined with chemotherapy

Galitis

Droukas

Tzakis

et al. 2017

Forum of Clinical Oncology

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“…Myofascial pain can be present as trismus, contracture, fibrosis and scarring of the muscles of mastication and TMJ ligaments (61,65-67) compromising daily life activities such as eating because they can cause severe limitations of mouth opening. Therefore, it is recommended that the patient begins a physical therapy protocol before and after the procedure to maintain an optimal mouth opening.…”

Section: The Paradox Of Cancer Treatmentmentioning

confidence: 99%

Cancer and orofacial pain

Salvemini

2016

Med Oral

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BackgroundCancer pain is a devastating condition. Pain in the orofacial region, may be present as the single symptom of cancer or as a symptom of cancer in its later stages. This manuscript revises in a comprehensive manner the content of the conference entitled “Orofacial Pain and Cancer” (Dolor Orofacial y Cancer) given at the VI Simposio International “Advances in Oral Cancer” on the 22 July, 2016 in Donostia.Material and MethodsWe have reviewed (pubmed-medline) from the most relevant literature including reviews, systematic reviews and clinical cases, the significant and evidence-based mechanisms and mediators of cancer-associated facial pain, the diverse types of cancers that can be present in the craniofacial region locally or from distant sites that can refer to the orofacial region, cancer therapy that may induce pain in the orofacial region as well as discussed some of the new advancements in cancer pain therapy.ResultsThere is still a lack of understanding of cancer pain pathophysiology since depends of the intrinsic heterogeneity, type and anatomic location that the cancer may present, making more challenging the creation of better therapeutic options. Orofacial pain can arise from regional or distant tumor effects or as a consequence of cancer therapy.ConclusionsThe clinician needs to be aware that the pain may present the characteristics of any other orofacial pain disorder so a careful differential diagnosis needs to be given. Cancer pain diagnosis is made by exclusion and only can be reached after a thorough medical history, and all the common etiologies have been carefully investigated and ruled out. The current management tools are not optimal but there is hope for new, safer and effective therapies coming in the next years. Key words:Pain, orofacial, facial, cancer.

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Prevalence and prediction of trismus in patients with head and neck cancer: A cross‐sectional study

et al. 2018

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Background Trismus occurs frequently in patients with head and neck cancer. Determining the prevalence and associated factors of trismus would enable prediction of the risk of trismus for future patients. Methods Based on maximal mouth opening measurements, we determined the prevalence of trismus in 730 patients with head and neck cancer. Associated factors for trismus were analyzed using univariate analyses and multivariate logistic regression analyses. Based on the regression model, a calculation tool to predict trismus was made. Results Prevalence of trismus was 23.6%. Factors associated with trismus were: advanced age; partial or full dentition; tumors located at the maxilla; mandible; cheek; major salivary glands; oropharynx; an unknown primary; a free soft tissue transfer after surgery; reirradiation; and chemotherapy. Conclusion About one‐fourth of patients with head and neck cancer develop trismus. Based on prevalence and associated factors of trismus, a simple calculation tool predicts the risk of trismus in these patients.

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Mouth opening and trismus in patients undergoing curative treatment for head and neck cancer

Cited by 42 publications

References 24 publications

Trismus and reduced quality of life in patients with oral squamous cell carcinoma, who received post-operative radiotherapy alone or combined with chemotherapy

Trismus and reduced quality of life in patients with oral squamous cell carcinoma, who received post-operative radiotherapy alone or combined with chemotherapy

Cancer and orofacial pain

Prevalence and prediction of trismus in patients with head and neck cancer: A cross‐sectional study

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