The effects of antitumor irradiation on mandibular opening and mobility: A prospective study of 58 patients

Goldstein, Marc; Maxymiw, W.G.; Cummings, Bernard; Wood, Robert E.

doi:10.1016/s1079-2104(99)70044-2

Cited by 154 publications

(150 citation statements)

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“…The structures involved in mastication are the pterygoid, masseter, and temporalis muscles, and the mandibular condyle [13]. Restricted and/or painful mouth opening affect normal chewing and eating, and impair speech and oral hygiene [14,15] Studies that focused on radiation dose reduction and or structure avoidance, unfortunately, cannot easily be compared, because of their heterogeneity in tumor sites and treatment protocols, their overall retrospective nature, and their lack of objective assessments [1,16]. A systematic review of Roe et al [1] (papers published between January 1998 and December 2009) found only one prospective longitudinal study that consistently evaluated oropharyngeal swallow function, using both objective instrumental measures, as well as patient self-reports alongside established toxicity scores [17].…”

Section: Introductionmentioning

confidence: 66%

Dysphagia and trismus after concomitant chemo-Intensity-Modulated Radiation Therapy (chemo-IMRT) in advanced head and neck cancer; dose–effect relationships for swallowing and mastication structures

Molen

Heemsbergen

Jong

et al. 2013

Radiotherapy and Oncology

108

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General rightsIt is not permitted to download or to forward/distribute the text or part of it without the consent of the author(s) and/or copyright holder(s), other than for strictly personal, individual use, unless the work is under an open content license (like Creative Commons). Disclaimer/Complaints regulationsIf you believe that digital publication of certain material infringes any of your rights or (privacy) interests, please let the Library know, stating your reasons. In case of a legitimate complaint, the Library will make the material inaccessible and/or remove it from the website. Please Ask the Library: http://uba.uva.nl/en/contact, or a letter to: Library of the University of Amsterdam, Secretariat, Singel 425, 1012 WP Amsterdam, The Netherlands. You will be contacted as soon as possible. Prospective assessment of dysphagia and trismus in chemo-IMRT head and neck cancer patients in relation to dose-parameters of structures involved in swallowing and mastication. Material and Methods:Assessment of 55 patients before, 10-weeks (N=49) and 1-year post-treatment (N=37). Calculation of dose-volume parameters for swallowing (inferior (IC), middle (MC), and superior constrictors (SC)), and mastication structures (e.g. masseter). Investigation of relationships between dose-parameters and endpoints for swallowing problems (videofluoroscopy-based laryngeal Penetration-Aspiration Scale (PAS), and study-specific structured questionnaire) and limited mouth-opening (measurements and questionnaire), taking into account baseline scores. Results:At 10-weeks, volume of IC receiving ≥60Gy (V60) and mean dose IC were significant predictors for PAS. One-year post-treatment, reported problems with swallowing solids were significantly related to masseter dose-parameters (mean, V20, V40 and V60) and an inverse relationship (lower dose related to a higher probability) was observed for V60 of the IC. Dose-parameters of masseter and pterygoid muscles were significant predictors of trismus at 10-weeks (mean, V20, and V40). At 1-year, doseparameters of all mastication structures were strong predictors for subjective mouth-opening problems (mean, max, V20, V40, and V60). Conclusions:Dose-effect relationships exist for dysphagia and trismus. Therefore treatment plans should be optimized to avoid these side effects.

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Section: Introductionmentioning

confidence: 66%

Dysphagia and trismus after concomitant chemo-Intensity-Modulated Radiation Therapy (chemo-IMRT) in advanced head and neck cancer; dose–effect relationships for swallowing and mastication structures

Molen

Heemsbergen

Jong

et al. 2013

Radiotherapy and Oncology

108

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“…In the literature, it is hypothesized that trismus is the result of fibrosis of the muscles and ligaments adjacent to the temporomandibular joint and pterygoid muscles. 14,15 In our patients, the symptoms of trismus and facial/jaw pain were, therefore, likely unrelated to hyoid ORN but rather were caused by the direct effect of radiation therapy on the masticator soft tissues. Therefore, the signs and symptoms associated with hyoid ORN may well occur in patients who do not have necrosis, and conversely, no specific symptom would likely suggest hyoid ORN to the clinician.…”

Section: Discussionmentioning

confidence: 99%

Osteoradionecrosis of the Hyoid Bone: Imaging Findings

Yoo

Rosenthal

Mitchell

et al. 2009

AJNR Am J Neuroradiol

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“…The chewing muscles or the temporomandibular joint (TMJ), when they are enclosed in a radiation field, may lead to the formation of tissue fibrosis, muscle spasms and restricted mouth opening, or trismus 3 .…”

Section: Introductionmentioning

confidence: 99%

Limitation of mouth opening after radiotherapy for head and neck

Caetano

Castro²,

Castro³

et al. 2016

RGO, Rev. Gaúch. Odontol.

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Objective To evaluate the ability to open the mouth in patients undergoing radiotherapy for head and neck and the variables related to this limitation. Methods patients were evaluated six months after completion of radiotherapy sessions to treat cancer in the head RESUMOObjetivo Avaliar a capacidade de abertura bucal de pacientes submetidos a tratamento radioterápico de cabeça e as variáveis relacionadas à sua limitação. MétodosForam analisados 32 pacientes seis meses após o término das sessões de radioterapia para tratamento de câncer em região de cabeça e pescoço. A medida da abertura bucal máxima foi aferida por meio de um paquímetro digital e sua associação com as variáveis sexo, idade, tabagismo, etilismo, localização do tumor, realização de quimioterapia e cirurgia foram analisadas com os testes U de Mann-Whitney e KruskalWallis no nível de significância de 95%. ResultadosA idade média dos pacientes foi de 60,44 anos; 87,5% eram do sexo masculino; 81,2% eram tabagistas; 65,6% eram etilistas. A média de abertura bucal foi de 43,17mm e sete pacientes (21,9%) apresentavam trismo. As localizações mais frequentes dos tumores foi a língua (31,3%), seguida da laringe e da prega vocal com cinco (15,6%) cada uma. Não foi encontrada associação entre a limitação de abertura bucal e as variáveis estudadas. ConclusãoNa amostra estudada, 21,9% dos pacientes apresentaram trismo seis meses após o término do tratamento radioterápico. As variáveis sexo, hábitos de etilismo e tabagismo, localização do tumor, cirurgia prévia e quimioterapia adjuvante não estiveram associados à limitação de abertura bucal.Termos de indexação: Neoplasias de cabeça e pescoço. Boca. Radioterapia. Limitation of mouth opening after radiotherapy for head and neck Limitação de abertura bucal pós-radioterapia de cabeça e pescoço 25Limitation of mouth opening after radiotherapy for head and neck collected in respect of age, the social habits of smoking and alcohol consumption, tumor location, performance of adjunctive treatment (chemotherapy and/or surgery) and the measurement of the mouth opening.The mouth opening capacity was checked using digital calipers (Pantec -São Paulo, Brazil). In those patients who still have their teeth, the distance was measured between the incisal edge of the upper and lower incisors (11, 41); patients with an edentulous lower arch and without the use of a prosthesis, the distance between the incisal edge of tooth 11 and the lower alveolar ridge (region of tooth 41); patients with an edentulous upper arch and without the use of a prosthesis, the distance between the incisal edge of tooth 41 and the alveolar ridge (region of tooth 11); edentulous patients using prostheses, the distance between the upper and lower dentures was measured, or if the patient had no prosthesis, the maximum distance between the two alveolar ridges (location of teeth 11 and 41) was measured, as described by Dijkstra et al. 7 A patient was deemed to be suffering from trismus when his/her maximum mouth opening was less than 35 mm 7 .The dat...

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The effects of antitumor irradiation on mandibular opening and mobility: A prospective study of 58 patients

Cited by 154 publications

References 3 publications

Dysphagia and trismus after concomitant chemo-Intensity-Modulated Radiation Therapy (chemo-IMRT) in advanced head and neck cancer; dose–effect relationships for swallowing and mastication structures

Dysphagia and trismus after concomitant chemo-Intensity-Modulated Radiation Therapy (chemo-IMRT) in advanced head and neck cancer; dose–effect relationships for swallowing and mastication structures

Osteoradionecrosis of the Hyoid Bone: Imaging Findings

Limitation of mouth opening after radiotherapy for head and neck

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