Evaluation of acute radiation effects on mandibular movements of patients with head and neck cancer

Trismus in oral cancer patients undergoing surgery and radiotherapy

“…8 The probability of developing trismus is reported to increase 24% for every 10 Gy of additional radiation over 40 Gy delivered to the pterygoid muscles. 17 Althogh a few authors state that restriction of mouth opening may occur even at low doses of irradiation, 18 a steep dose effect relationship between radiation dose to the masticatory apparatus and trismus has been noted. 19,20 The high incidence of trismus in our study can be attributed to the use of external beam radiotherapy because trismus with conventional radiotherapy is reported to be 25.4%.…”

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

“…These studies were scored with “N/A” on the study participation domain (n = 32; 60%) (Table 2). 5,13,16,18,20,28,30,32,36,37,43,45‐47,51‐58,60,61,64,65,68,69,72,73,75,77 Eleven studies (21%) did not report attrition rate 13,19,33,35,51,55,61,70,72,73,77 . Some did not report the attrition rate because only the patients with complete data were included.…”

“…Four studies (8%) were scored with “N/A" on the outcome measurement domain 14,16,55,60 : two studies did not describe the measurement method 55,60 and two studies used a measurement method that has not been validated (extra‐oral measurements) 14,16 . The majority of the studies were scored with a high risk of bias concerning the statistical analysis and reporting domain (n = 42; 79%) because they lacked a multivariate analysis 5,13,14,17,18,20,28‐37,43,45‐47,51,52,54‐58,60‐68,70,72‐75,77 …”

“…A distinction was made between objective (eg, using a ruler or calliper) or subjective (eg, using a patient' questionnaire) assessments of restricted mouth opening. An additional distinction was made between the objective studies, namely using a restricted mouth opening as a cut‐off point (n = 6) 13,14,47‐50 or a decrease in MMO measured in millimeters (n = 16) 15,16,43,51‐63 …”

Prevalência e caracterização do trismo em pacientes tratados por câncer de cabeça e pescoço

“…Moreover, the need for enteral feeding may reflect severity of the disease and consequently, greater functional impairment. BRAGANTE et al (2012) showed that patients undergoing RDT for head and neck cancer using nasogastric feeding showed greater restriction in MVMO than those feeding orally. 20 JAGER-WITTENAAR et al (2011) evaluated nutrition, dietary intake (enteral vs. oral) and oral symptoms including trismus, but they did not explore the possible relationships between these factors.…”