Trismus Release in Oral Cancer Patients

Abstract

Trismus is a common problem among oral cancer patients. This report aimed to study the inciting factors of trismus and to find out the rationale of trismus release. Between 1996 and 2008, 61 oral cancer patients with retrievable records of interincisor distance (IID) were analyzed by retrospective chart review. The IID decreased from 31.4 (12.4) to 24.9 (12.0) mm in 36 patients undergoing cancer ablation only (P = 0.001). Other variables prompting trismus include buccal cancer (P = 0.017), radiotherapy (P = 0.008), and recurrence (P = 0.001). In contrast, the IID improved from 11.7 (7.1) to 22.7 (11.9) mm in 25 patients receiving cancer ablative and trismus releasing surgeries (P = 0.000). The improvement fared better in individuals with IID less than 15 mm than the others (P = 0.037). In conclusion, involvement of buccal region, ablative surgery, radiotherapy, and recurrence are provocative factors of trismus. Patients with IID less than 15 mm will benefit from releasing surgery significantly. Others may better be handled with conservative managements firstly, and enrolled as candidates of surgical release only until the patients entertained a 28-month period of disease-free interval, by which time the risk of recurrence would be markedly reduced.

Trismus surgical release and free flap reconstruction after radiation therapy in oral and oropharyngeal squamous cell carcinoma

“…As their IID starting point is worse, even if they are expected to have a high recurrence rate, the benefit they will obtain after the release surgery will be more significant than patients who had an initially higher PO‐IID. The same inversely proportional results between PO‐IID and LT‐ gain were observed in the study by Chan et al in patients with oral submucous fibrosis, and by Lee et al in patients after oral cancer treatment.…”

“…When reviewing the literature, focus has been mainly directed to the effect of radiotherapy in trismus, or the result of free flap reconstruction after trismus release in patients with oral submucous fibrosis . Few articles describe the result of free flap reconstruction after oral cancer treatment . and not enough emphasis seems to be given on how the effect of previous radiotherapy, which has been described as such an important factor in the etiopathogenesis of trismus development, may affect the final result of the reconstruction.…”

Trismus: un reto en la rehabilitación oncológica

“…El trismus provoca implicaciones significativas en la salud y las actividades de la vida diaria, pues está asociado a dolor, problemas del habla, dificultad para la deglución, desnutrición, deshidratación, dificultad para la higiene oral, aislamiento social y menor calidad de vida 2,3 .…”

“…Estas herramientas incluyen tapones de goma, depresores de lengua (paletas de madera), aparatos de TheraBite® y abridores de mordedura dinámicos 3,5,6 .…”

“…Entre los que se incluye los carcinomas de labio, cavidad oral, nasofaringe, orofaringe, hipofaringe, laringe, senos paranasales, glándulas salivales y metástasis cervicales de primario desconocido. La resección quirúrgica, la radioterapia y la quimioradioterapia son las modalidades primarias para el tratamiento de este tipo de tumores 2,3,5 . Si bien se sabe, el trismus puede ocurrir como un problema preexistente o desarrollarse como una secuela en el tratamiento del cáncer, la frecuencia y gravedad es algo impredecible.…”