Prevalence of Trismus and Its Impact on Oral Health-Related Quality of Life in Patients Treated for Oral Squamous Cell Carcinoma

Abstract

Oral squamous cell carcinoma, one of the most common malignancies, has a poor prognosis due to impairment in oral functions secondary to treatment. Trismus one of the major causes of impairment of oral function. The present study investigated the prevalence of trismus and its impact on oral health-related quality of life (OHRQoL) in patients treated for oral squamous cell carcinoma (OSCC). The maximum inter-incisal mouth opening of hundred OSCC patients was recorded at post-treatment and 3 months post-treatment. OHRQoL questionnaire (OHIP-14) was intervened to assess the OHRQoL of patients post-treatment and 3 months follow-up, with emphasis on correlation with grades of trismus. The prevalence of trismus was 16% pre-treatment, 72% post-treatment, and 62% at 3 months after treatment. The overall OHIP-14 scores indicated that patients with trismus reported greater impairment of OHRQoL than those without trismus at the end of treatment and 3 months follow-up. At the end of treatment, patients with severe trismus demonstrated a higher mean OHIP-14 score (23.47 ±3.34) than those with moderate (17.72 ±2.83) and mild trismus (12.66 ±3.84) with statistically significant differences (p<0.001). Equivalent results were obtained at 3 months follow-up period. Patients with trismus suffer greater impairment of OHRQoL. The findings demand the need of identifying risk factors for developing trismus and early institution of newer/modified treatment approaches for better OHRQoL in OSCC survivors.

The predictive usefulness of the novel “combined hemoglobin‐to‐platelet ratio and maximum mouth opening index” on prevalence of radiation induced trismus in patients with nasopharyngeal cancer

“…The authors reported that patients presenting with RIT had significantly lower head and neck-specific quality of life in terms of social contact, sexuality, teeth, mouth opening, dry mouth, feeling ill, nutritional supplement, and weight loss. Lee's findings were consistent with those of previous research, 37,43,44 all of which confirm the negative effects of RIT on all domains of quality-of-life measures. Hence, if backed up with further research findings, the risk classification introduced here might aid in the prompt implementation of risk-based preventive and/or therapeutic strategies, thus lowering the occurrence of highly debilitating RIT and its negative impacts in some patient groups, particularly the intermediate and high-risk patients.…”

Transoral Robotic Surgery for Oral Cancer: Evaluating Surgical Outcomes in the Presence of Trismus

“…This observation emphasizes the importance of surgical innovation in enhancing treatment accessibility and effectiveness for patients facing complex clinical presentations. According to previous studies, some mechanisms may further explain the worse survival outcomes in oral cancer patients with trismus [ 9 , 26 , 27 , 28 ]. The potential impact of trismus on overall survival may be mediated through the emergence of dysphagia, culminating in malnutrition and the risk of aspiration [ 29 ].…”

“…In Taiwan, this condition is particularly prevalent among those who habitually chew betel quid, a practice known to contribute to oral submucosal fibrosis (OSMF) and oral cancer risk [ 6 , 7 ]. While the debilitating effects of post-treatment trismus on patients’ quality of life are well documented [ 8 , 9 ], the impact of preoperative trismus on surgical outcomes in oral cancer patients, particularly those undergoing transoral robotic surgery (TORS), remain underexplored. This oversight persists despite evidence suggesting that preoperative trismus, irrespective of the surgical method, poses significant challenges to surgical access [ 10 , 11 , 12 , 13 , 14 ].…”

“…Recent studies have provided insights into the broader implications of trismus. For instance, a 2021 study by Gondivkar et al highlighted the correlation between trismus severity and reduced quality of life in oral cancer patients [ 9 ]. Another cross-sectional study emphasized the need for early identification and proactive management of trismus, thereby amplifying the potential for improved therapeutic outcomes [ 15 ].…”

Association of Neoadjuvant Pembrolizumab for Oral Cavity Squamous Cell Carcinoma With Adverse Events After Surgery in Treatment-Naive Patients

“…A rather surprising finding in this study was the substantially lower rate of postoperative trismus among patients who received preoperative immunotherapy. Trismus is a common adverse effect of head and neck cancer treatment and is a distressing symptom that can drastically diminish one’s quality of life . Trismus from surgery results from the disruption of the muscles of mastication, particularly the pterygoids, or the temporomandibular joint.…”