抗肿瘤放疗对下颌开口及活动度的影响：一项针对58例患者的前瞻性研究。

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

作者信息

Goldstein M, Maxymiw W G, Cummings B J, Wood R E

机构信息

Department of Dentistry, Ontario Cancer Institute/Princess Margaret Hospital, Toronto, Canada.

出版信息

Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999 Sep;88(3):365-73. doi: 10.1016/s1079-2104(99)70044-2.

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

PMID:10503870

Abstract

OBJECTIVE

The purpose of this study was to analyze the effects of head and neck radiation therapy on jaw opening and mobility.

STUDY DESIGN

Maximum jaw opening and mandibular mobility were measured before and after radiation treatment in 58 patients presenting for angle down wedge, homolateral wedge pair, and parallel pair head and neck radiation treatment.

RESULTS

As dose to the temporomandibular joint and pterygoid muscles increased, maximal jaw opening decreased linearly. Mandibular dysfunction appeared to increase as radiation dose to the pterygoid muscles increased. Similar effects were not observed with temporomandibular joint irradiation. Irradiation of the pterygoid muscles appeared critical in the development of trismus. Angle down wedge treatment irradiated the temporomandibular joint and pterygoid muscles with clinical effects similar to those seen in homolateral wedge pair and parallel pair patients. Doses as low as 1493 cGy resulted in functional impairment.

CONCLUSIONS

Future investigations into radiotherapy delivery and appropriate postradiation trismus treatment may reduce head and neck radiation morbidity.

摘要

目的

本研究旨在分析头颈部放射治疗对张口度和下颌运动的影响。

研究设计

对58例接受角向下楔形、同侧楔形对和平行对头颈部放射治疗的患者，在放射治疗前后测量其最大张口度和下颌运动度。

结果

随着颞下颌关节和翼状肌所受剂量增加，最大张口度呈线性下降。随着翼状肌放射剂量增加，下颌功能障碍似乎增加。颞下颌关节照射未观察到类似效果。翼状肌照射似乎在牙关紧闭的发生中起关键作用。角向下楔形治疗照射颞下颌关节和翼状肌，其临床效果与同侧楔形对和平行对患者相似。低至1493厘戈瑞的剂量即可导致功能损害。