Grandi Gisela, Silva Miguel Luciano, Streit Carla, Wagner João Carlos B
Oral and Maxillofacial Surgery , Porto Alegre, RS, Brasil.
Med Oral Patol Oral Cir Bucal. 2007 Mar 1;12(2):E105-9.
Radiotherapy, when used in head and neck cancer treatment, can produce side effects in the patients, such as decreased salivary production, xerostomia, opportunistic infections, radiation caries, dysphagia, local discomfort and the limitation of mouth opening. The aim of this study was to evaluate the amplitude of mouth opening in patients before and immediately after the completion of radiotherapy, comparing the effectiveness of two physiotherapy exercises. The irradiated sites included the masticatory muscles. The results demonstrated that there were no statistically significant differences between the two instituted exercises; however there was a trend towards better clinical results in group 2. The amplitude of mouth opening showed a trend towards reduction, but this was not statistically significant. When the pterygoid and sternocleidomatoid muscles were included in the irriated field, patients were observed to have more morbidity. This indicates the great importance of these muscles in mouth opening. Based on the results obtained within this study, it is not possible to conclude that physiotherapy exercies are efficacious in preventing trismus. Future longitudinal studies are required to verify the onset of trismus in radiotherapy patients.
放射治疗用于头颈癌治疗时，会给患者带来一些副作用，如唾液分泌减少、口干、机会性感染、放射性龋齿、吞咽困难、局部不适以及张口受限。本研究的目的是评估放疗完成前和刚完成后患者的张口幅度，比较两种物理治疗练习的效果。照射部位包括咀嚼肌。结果表明，两种既定练习之间没有统计学上的显著差异；然而，第2组有临床效果更好的趋势。张口幅度呈减小趋势，但这在统计学上并不显著。当翼状肌和胸锁乳突肌被纳入照射野时，观察到患者有更多的发病率。这表明这些肌肉在张口方面非常重要。基于本研究获得的结果，无法得出物理治疗练习对预防牙关紧闭有效的结论。未来需要进行纵向研究来验证放疗患者牙关紧闭的发病情况。
