Steiner F, Evans J, Marsh R, Rigby P, James S, Sutherland K, Wickens R, Nedev N, Kelly B, Tan S T
Gillies McIndoe Research Institute, Wellington, New Zealand.
Wellington Blood and Cancer Centre, Wellington Regional Hospital, Wellington, New Zealand.
Int J Oral Maxillofac Surg. 2015 Mar;44(3):292-6. doi: 10.1016/j.ijom.2014.12.009. Epub 2015 Jan 7.
This study documents mouth opening and the incidence of and factors contributing to trismus (<35 mm mouth opening), as well as the associated impact on quality of life, following curative treatment for head and neck cancer. Patient demographics, cancer type and location, and treatments were documented. Mouth opening was measured at >6 months after treatment completion. Patients rated the impact of mouth opening on quality of life from 0 (no effect) to 10 (greatest effect). The mean mouth opening in 120 patients was 40.1mm (range 11-65 mm), with trismus occurring in 34 (28.3%) patients. Surgery and radiotherapy, surgery and chemoradiotherapy, and resection and reconstruction were associated with reduced mouth opening. The mean effect of mouth opening on quality of life for those with and without trismus was 3.8 and 1.5, respectively. There was a significant difference between the mean effect on quality of life for patients with and without trismus for those patients who underwent chemoradiotherapy or combined surgery and radiotherapy (4.0 vs. 1.0, and 3.6 vs. 1.6 respectively). Trismus impacts negatively on patient quality of life. Multi-modality treatment is associated with decreased mouth opening, an increased incidence of trismus, and reduced quality of life.
本研究记录了头颈癌根治性治疗后患者的张口情况、牙关紧闭（张口度<35mm）的发生率及相关因素，以及其对生活质量的影响。记录了患者的人口统计学信息、癌症类型和位置以及治疗方法。在治疗结束>6个月时测量张口度。患者对张口对生活质量的影响从0（无影响）到10（影响最大）进行评分。120例患者的平均张口度为40.1mm（范围11 - 65mm），34例（28.3%）患者发生牙关紧闭。手术与放疗、手术与放化疗以及切除与重建均与张口度降低有关。有和没有牙关紧闭的患者，张口对生活质量的平均影响分别为3.8和1.5。对于接受放化疗或手术与放疗联合治疗的患者，有和没有牙关紧闭的患者对生活质量的平均影响存在显著差异（分别为4.0对1.0和3.6对1.6）。牙关紧闭对患者生活质量有负面影响。多模式治疗与张口度降低、牙关紧闭发生率增加以及生活质量下降有关。
