Astradsson Thorsteinn, Laurell Göran, Ahlberg Alexander, Nikolaidis Polymnia, Johansson Hemming, Ehrsson Ylva Tiblom
a Department of Surgical Sciences, Section of Otorhinolaryngology and Head & Neck Surgery , Uppsala University , Uppsala , Sweden.
b Department of Otorhinolaryngology - Head & Neck Surgery , Karolinska University Hospital , Stockholm , Sweden.
Acta Otolaryngol. 2018 Dec;138(12):1123-1127. doi: 10.1080/00016489.2018.1511059. Epub 2019 Jan 27.
Trismus is a common complication of radiotherapy for head and neck cancer but its impact on survival is unknown.
AIMS/OBJECTIVES: This prospective study evaluates the incidence of trismus in patients with head and neck cancer receiving radiotherapy and the impact of trismus on 5-year overall survival.
Two hundred forty-four patients with head and neck cancer were included. All patients received instructions on jaw exercises and were evaluated before initiation of radiotherapy and at 2, 6, and 12 months after termination of radiotherapy.
One year after treatment 25% had a reduced maximum interincisal opening (MIO) of 13 mm or more as compared to the pretreatment MIO. Trismus was most prevalent in patients with oral and oropharyngeal cancer. A trend towards worse 5-year overall survival was seen among patients with trismus.
The trismus rate was approximately 30% at 12 months. Jaw exercises should primarily be offered to patients with oral and oropharyngeal cancer who are most likely to benefit. Further studies are required to investigate the effect of trismus on survival.
This study identifies patients likely to benefit from jaw exercises and provides basis for further research on trismus and survival.
牙关紧闭是头颈癌放疗常见的并发症，但其对生存率的影响尚不清楚。
本前瞻性研究评估接受放疗的头颈癌患者牙关紧闭的发生率以及牙关紧闭对5年总生存率的影响。
纳入244名头颈癌患者。所有患者均接受了下颌运动锻炼指导，并在放疗开始前以及放疗结束后2个月、6个月和12个月进行评估。
治疗1年后，25%的患者最大切牙间开口度（MIO）较治疗前降低了13毫米或更多。牙关紧闭在口腔癌和口咽癌患者中最为常见。牙关紧闭患者的5年总生存率有变差的趋势。
12个月时牙关紧闭率约为30%。下颌运动锻炼应主要提供给最可能从中受益的口腔癌和口咽癌患者。需要进一步研究以调查牙关紧闭对生存率的影响。
本研究确定了可能从下颌运动锻炼中受益的患者，并为进一步研究牙关紧闭与生存率提供了依据。
