Dijkstra P U, Huisman P M, Roodenburg J L N
Department of Oral and Maxillofacial Surgery, Division Oncology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
Int J Oral Maxillofac Surg. 2006 Apr;35(4):337-42. doi: 10.1016/j.ijom.2005.08.001. Epub 2005 Nov 8.
The aim of this study was to determine a functional cut-off point for trismus in head and neck oncology. In total, 89 patients (13 dentate, 30 partially dentate and 46 edentulous) treated for cancer of the oral cavity or oropharynx were asked whether they experienced a limited mouth opening. The mandibular function impairment questionnaire (MFIQ) was filled out and mouth opening was measured. The proportion correctly predicted (proportion true positives+proportion true negatives) was calculated. For cut-off points from 25 to 45 mm, differences in MFIQ scores of the restricted and non-restricted groups were analyzed. A receiver operating curve was constructed. The proportion correctly predicted was highest for cut-off point <or=35 mm (0.81), with a sensitivity of 0.71 and a specificity of 0.98. Differences in perceived mandibular function impairments were significant for all cut-off points of 35 mm or less. For the total group, the area under curve was 0.87. For the subgroups of dentate, partially dentate and edentulous patients, no consistent cut-off points could be found on the basis of the proportion correctly predicted and the significance of the difference in MFIQ scores. A mouth opening of <or=35 mm is a functional cut-off point for trismus in head and neck oncology patients.
本研究的目的是确定头颈部肿瘤患者牙关紧闭的功能截断点。总共89例接受口腔或口咽癌治疗的患者（13例有牙、30例部分有牙和46例无牙）被询问是否存在张口受限。填写下颌功能障碍问卷（MFIQ）并测量张口度。计算正确预测的比例（真阳性比例+真阴性比例）。对于25至45毫米的截断点，分析受限组和非受限组MFIQ评分的差异。构建受试者工作特征曲线。截断点≤35毫米时正确预测的比例最高（0.81），灵敏度为0.71，特异度为0.98。对于所有35毫米及以下的截断点，感知到的下颌功能障碍差异均具有显著性。对于整个组，曲线下面积为0.87。对于有牙、部分有牙和无牙患者亚组，基于正确预测的比例和MFIQ评分差异的显著性，未发现一致的截断点。张口度≤35毫米是头颈部肿瘤患者牙关紧闭的功能截断点。
