Agarwal Padmanidhi, Shiva Kumar H R, Rai Kirthi Kumar
Department of Oral and Maxillofacial Surgery, King George's Medical University, Lucknow, India.
Department of Oral and Maxillofacial Surgery, Bapuji Dental College and Hospital, Davangere, India.
J Oral Biol Craniofac Res. 2016 Nov;6(Suppl 1):S9-S13. doi: 10.1016/j.jobcr.2016.10.004. Epub 2016 Oct 22.
The aim of this study was to determine the incidence of trismus before and after surgery and subsequent radiotherapy for patients of oral cancer and to determine the risk factors for the same.
30 patients diagnosed with oral cancer were included. Maximum mouth opening was measured for each patient as the inter incisal distance and was measured on 4 occasions - preoperatively at the time of diagnosis, post-operatively at discharge from the hospital, post-radiotherapy and at 6 months follow-up. The site of cancer, staging and grading of the malignancy, the surgical treatment performed, method of reconstruction, details of radiotherapy and compliance to physiotherapy were recorded, to evaluate the risk factors for developing trismus.
Trismus was observed in 53.3% patients at the time of diagnosis which increased significantly post-surgery (86.7%) and post-radiotherapy (85.7%) and gradually decreased (65.4%) at 6 months. The use of flaps for reconstruction, delay in radiotherapy post-surgery and non-compliance of patients to physiotherapy were the risk factors for developing trismus, showing statistical significance ( < 0.05).
Trismus is a significant complication of oral malignancies or its surgical and radiotherapy treatment, or both. Consideration must be given to its early diagnosis, to help in timely intervention and planning of preventive strategies.
本研究旨在确定口腔癌患者手术及后续放疗前后牙关紧闭的发生率，并确定其危险因素。
纳入30例诊断为口腔癌的患者。测量每位患者的最大开口度，即切牙间距离，并在4个时间点进行测量——诊断时术前、出院时术后、放疗后以及随访6个月时。记录癌症部位、恶性肿瘤的分期和分级、所进行的手术治疗、重建方法、放疗细节以及物理治疗的依从性，以评估发生牙关紧闭的危险因素。
诊断时53.3%的患者出现牙关紧闭，术后（86.7%）和放疗后（85.7%）显著增加，6个月时逐渐下降（65.4%）。使用皮瓣重建、术后放疗延迟以及患者未依从物理治疗是发生牙关紧闭的危险因素，具有统计学意义（<0.05）。
牙关紧闭是口腔恶性肿瘤及其手术和放疗治疗（或两者）的一种重要并发症。必须考虑对其进行早期诊断，以有助于及时干预和制定预防策略。
