Raj Radhu, Thankappan Krishnakumar, Janakiram Chandrasekhar, Iyer Subramania, Mathew Anil
Department of Prosthodontics, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India.
Department of Head and Neck Surgery and Oncology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India.
Craniomaxillofac Trauma Reconstr. 2020 Sep;13(3):219-225. doi: 10.1177/1943387520917518. Epub 2020 Apr 27.
Trismus refers to a person's inability to normally open his or her mouth. Trismus can occur as a symptom due to tumor ingrowth or it can occur postsurgical following the treatment for head and neck cancer. Radiation-induced trismus is also a relatively common oral complication. This review aimed at reviewing the etiopathogenesis of trismus in patients with head and neck cancer. Of the 16 publications included after final screening, of which one was a nonrandomized control trial, one a randomized control trial, 6 prospective cohort studies, and 8 retrospective cohort studies. Among them, 6 articles addressed the possible mechanism for trismus related to tumor ingrowth, 8 articles suggested the likely reason for trismus in patients who had undergone radiation therapy and 2 articles addressed the postsurgical cause for trismus. This review highlights the possible involvement of infratemporal fossa as a predetermining factor for developing trismus related to tumor extension. The molecular mechanism of radiation-induced fibrosis is well studied in the literature.
牙关紧闭是指一个人无法正常张开嘴巴。牙关紧闭可能作为肿瘤向内生长的症状出现，也可能在头颈癌治疗后的手术后发生。放射性牙关紧闭也是一种相对常见的口腔并发症。本综述旨在回顾头颈癌患者牙关紧闭的发病机制。最终筛选纳入的16篇文献中，1篇为非随机对照试验，1篇为随机对照试验，6篇为前瞻性队列研究，8篇为回顾性队列研究。其中，6篇文章探讨了与肿瘤向内生长相关的牙关紧闭的可能机制，8篇文章提出了接受放射治疗患者发生牙关紧闭的可能原因，2篇文章探讨了手术后牙关紧闭的原因。本综述强调了颞下窝可能作为与肿瘤扩展相关的牙关紧闭发展的决定性因素。放射诱导纤维化的分子机制在文献中已有充分研究。
