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头颈癌患者颞下颌关节紊乱病的患病率及症状

The prevalence and symptoms of temporomandibular disorders in head and neck cancer patients.

作者信息

Saghafi Ellie, Tuomi Lisa, Kjeller Göran

机构信息

Department of Oral and Maxillofacial Surgery, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

Department of Orofacial Pain, Region Västra Götaland, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

出版信息

Acta Odontol Scand. 2022 May;80(4):252-257. doi: 10.1080/00016357.2021.1991470. Epub 2021 Oct 15.

Abstract

OBJECTIVES

This retrospective patient survey aimed to assess the prevalence of temporomandibular disorders (TMD) before and after curative oncological treatment and to identify possible risk factors.

MATERIALS AND METHODS

Patients with squamous cell carcinoma in the tonsil or base of the tongue were included ( = 217). Medical records were collected to assess TMD prevalence before oncological treatment and at 6- and 12-month follow-up. Fisher's test and Pitman's test were used.

RESULTS

Significantly reduced mouth opening was observed after oncological treatment at 6- and 12-month follow-up ( < .001). Symptoms from the temporomandibular joint and jaw muscles plus pain upon palpation ( = .0083,  < .001, respectively) and self-reported pain upon chewing (<0.001) and opening the mouth (<0.001) increased 12 months following radiotherapy. Pain and degree of mouth opening prior to treatment, self-reported depression, overall health status, brachytherapy and jaw exercise during radiotherapy were factors affecting the increase of TMD symptoms.

CONCLUSION

All TMD symptoms escalated significantly one year after radiotherapy except self-reported sounds from the temporomandibular joint. Reduction in the degree of mouth opening and pain in the jaw muscles and the temporomandibular joint when opening the mouth and upon chewing were commonly reported symptoms following radiotherapy. Several potential risk factors were identified.

摘要

目的

这项回顾性患者调查旨在评估根治性肿瘤治疗前后颞下颌关节紊乱病(TMD)的患病率,并确定可能的风险因素。

材料与方法

纳入扁桃体或舌根鳞状细胞癌患者(n = 217)。收集医疗记录以评估肿瘤治疗前以及6个月和12个月随访时的TMD患病率。使用Fisher检验和Pitman检验。

结果

在6个月和12个月随访的肿瘤治疗后观察到张口度显著降低(P <.001)。颞下颌关节和咀嚼肌症状加上触诊时的疼痛(分别为P = 0.0083,P <.001)以及自我报告的咀嚼时疼痛(P <0.001)和张口时疼痛(P <0.001)在放疗后12个月增加。治疗前的疼痛和张口度、自我报告的抑郁、总体健康状况、近距离放射治疗以及放疗期间的下颌运动是影响TMD症状增加的因素。

结论

除了自我报告的颞下颌关节弹响外,放疗一年后所有TMD症状均显著加重。放疗后常见的症状是张口度降低以及张口和咀嚼时咀嚼肌和颞下颌关节疼痛。确定了几个潜在风险因素。

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