“…MIO was measured using digital caliper in millimeter. (Dijkstra et al, 2006) Trismus was classified based on criteria as mild (31-35 mm), moderate (26-30 mm) and severe (< 25 mm) (Thomas et al, 1988;Martins et al, 2020). In edentulous patients, distance between alveolus ridge was measured.…”
Section: Data Collection and Qol Instrument Usedmentioning
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.
“…MIO was measured using digital caliper in millimeter. (Dijkstra et al, 2006) Trismus was classified based on criteria as mild (31-35 mm), moderate (26-30 mm) and severe (< 25 mm) (Thomas et al, 1988;Martins et al, 2020). In edentulous patients, distance between alveolus ridge was measured.…”
Section: Data Collection and Qol Instrument Usedmentioning
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.
“…[ 8 ] Failure to clear any posttreatment PD suggests a deficiency in tumor surveillance and consequently causes the progression of cancer. [ 21 ] A cohort study conducted by Qian et al . in the year 2020 to assess the elemental risk factors of oral cancer mortality revealed the impact of alveolar bone loss and missing teeth significantly increasing the risk of death in aged oral cancer patients.…”
Section: Oral Signs In Cachexia Associated With Oral Cancer Patientsmentioning
confidence: 99%
“…Trismus (restricted mouth opening) is mainly attributed to the invasion of the tumor, tumor-induced muscle spasm, RT-induced fibrosis, formation of edema after surgery or pain. [ 21 ] It is considered one of the late complications of the treatment of oral cancer. [ 22 ] It has a negative effect on the patient's quality of life as it influences their nutritional status.…”
Section: Oral Signs In Cachexia Associated With Oral Cancer Patientsmentioning
confidence: 99%
“…In addition, trismus is more commonly seen in completely edentulous patients which substantially decreases their ability of mastication. [ 21 ] Over the years, the survival rate of these patients has drastically reduced and may result in permanent sequelae of cachexia. [ 22 ]…”
Section: Oral Signs In Cachexia Associated With Oral Cancer Patientsmentioning
“…Trismus is known to have a signi cant impact on patient's daily activities such as chewing, swallowing and speech resulting in impairment of health-related quality of life (HRQoL) [9]. Di culty in maintaining optimal oral hygiene can contribute to the development of dental caries and other serious odontogenic infections [10]. Majority of the published literature is on prevalence and predictive risk factors associated with trismus, derived from retrospective and/ or, cross-sectional studies with HNC patients predominantly undergoing single treatment modality, either primary radiotherapy or primary surgery [4][5][6][11][12][13][14][15][16].…”
Purpose
Prospective evaluation of the change in maximum incisal opening (MIO) in patients receiving treatment for head neck cancer (HNC), and its interaction with clinical parameters such as tumor site/ sub-site and type of treatment received. Secondary aim was to ascertain the longitudinal change in dental caries experience and health-related quality of life (HRQoL) during the study period.
Methods
Seventy treatment-naïve patients undergoing treatment for squamous cell carcinoma (SCC) of oral cavity and/or oropharynx were assessed at 3 designated time-points; pre-treatment (T0), immediate post-treatment (T1) and 6-months post-treatment (T2). The primary study variable was change in MIO (cm) across 3 time points (T0, T1, T2). Dental caries incidence was measured using decayed, missing, filled teeth (DMFT) index and HRQoL was assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaires (EORTC QLQ-C30 and H&N-35). Change in DMFT and HRQoL was assessed between T0 and T2. Non-parametric repeated measures ANOVA was used to analyse the longitudinal change in MIO and DMFT scores and their interaction with clinical parameters respectively. Wilcoxon signed-rank test was used to compare corresponding HRQoL domains between T0 and T2. All statistical tests were 2-sided, and differences with a p-value < 0.05 were considered statistically significant.
Results
Sixty-seven eligible HNC patients showed a significant change in mouth-opening and dental caries experience from T0 to T2, irrespective of tumor site/ sub-site and type of treatment (p < 0.001). Site-wise, patients with oral cavity cancer and specifically maxillary tumors; treatment-wise those undergoing surgery and/or, multi-modal treatment showed persistently reduced mouth opening late post-treatment. There was a statistical increase in head-and-neck site specific HRQoL symptoms at T2. A high prevalence (69%) of post-treatment trismus was noted especially in patients undergoing multi-modality treatment (83%).
Conclusion
Patients undergoing treatment for HNC demonstrate a significant longitudinal change in mouth-opening and caries incidence. They may show partial recovery of MIO at 6-months after an initial decrease in the immediate post-treatment period.
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