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

Abstract

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.

Conhecimento de Universitários da Área da Saúde sobre o Câncer de Cavidade Oral

“…Esses resultados vão ao encontro aos achados por Souza e Carvalho 22 , ao dizerem que, em geral, o câncer de boca é assintomático, sendo que, em casos mais avançados, a dor possa existir. Outra complicação frequentemente relatada é a desnutrição relacionada ao CCO 23 , que, por vezes, pode estar relacionada ao trismo, o qual pode afetar a fala e a voz e prejudicar a mastigação e a deglutição 24,25 .…”

Orofacial Myofunctional Therapy with and without Photobiomodulation in the Rehabilitation of Radiation-Induced Trismus: Case Series

“…The level of muscle fatigue tends to be influenced by LASER due to the increase in the microcirculation of the irradiated anatomical region, which allows the re-establishment of muscle resistance, which may explain the greater tolerance of P4, P5 and P6 (PBM+OMT group) to exercise protocol. As for fatigue, P2, which only after orofacial myofunctional therapy obtained a score of 29 in the GTQ, indicating that higher hand muscle levels end fatigue three months of treatment [12]. Considering the value equal to or greater than 35 mm as a criterion of normality, patients with PBM therapy reached levels above the established standard after the intervention.…”

“…The GTQ is used as a screening to measure the impact of trismus on aspects related to dietary limitations, fatigue and muscle tension, as well as problems related to the jaw. In each domain, the research subject answered the questions by marking the most convenient answer qualitatively (e.g., responding about the existence of jaw fatigue as "not at all", "mild", "moderate", "severe", "very severe") and scores were assigned to the items in such a way that a higher score meant worse performance in quality of life with regard to trismus [12]. The VAS aimed to subjectively measure the perception of pain experienced by patients before and after therapeutic procedures.…”

Tratamento odontológico em pacientes oncológicos

“…Em casos de neoplasias localizadas na região de cabeça e pescoço, a média de radiação varia entre doses de 50-70Gy, com o principal objetivo de destruir as células neoplásicas. Assim como a quimioterapia, o tratamento através da radiação acomete as células vizinhas, podendo acarretar em problemas como a hipossalivação, condição em que ocorre a diminuição do fluxo salivar, tornando o meio bucal propício ao desenvolvimento de problemas orais (Paim, 2018;Marrafon, 2018).…”