scholarly journals The use of stretching devices for treatment of trismus in head and neck cancer patients: a randomized controlled trial

2019 ◽  
Vol 28 (1) ◽  
pp. 9-11 ◽  
Author(s):  
Sarah J. van der Geer ◽  
Harry Reintsema ◽  
Jolanda I. Kamstra ◽  
Jan L. N. Roodenburg ◽  
Pieter U. Dijkstra
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Mouth Opening ◽  
Exercise Protocol ◽  
Rehabilitation System ◽  
Maximal Mouth Opening ◽  
Study Population ◽  
Stretching Exercises

Abstract Purpose To compare the effects of two stretching devices, the TheraBite® Jaw Motion Rehabilitation System™ and the Dynasplint Trismus System®, on maximal mouth opening in head and neck cancer patients. Methods Patients were randomly assigned to one of two exercise groups: the TheraBite® Jaw Motion Rehabilitation System™ group or the Dynasplint Trismus System® group. Patients performed stretching exercises for 3 months. During the three study visits, maximal mouth opening was measured and the patients completed questionnaires on mandibular function and quality of life. Results In our study population (n = 27), five patients did not start the exercise protocol, eight patients discontinued exercises, and two patients were lost to follow-up. No significant differences regarding the change in mouth opening between the two devices were found. Patients had an increase in MMO of 3.0 mm (IQR − 2.0; 4.0) using the TheraBite® Jaw Motion Rehabilitation System™ and 1.5 mm (IQR 1.0; 3.0) using the Dynasplint Trismus System®. Exercising with either stretching device was challenging for the patients due to the intensive exercise protocol, pain during the exercises, fitting problems with the stretching device, and overall deterioration of their medical condition. Conclusions The effects of the two stretching devices did not differ significantly in our study population. The factors described, influencing the progression of stretching exercises, need to be taken into account when prescribing a similar stretching regimen for trismus in head and neck cancer patients. Trial registration NTR - Dutch Trial Register number: 5589

Prevention and treatment of trismus in head and neck cancer: A case report and a systematic review of the literature

2010 ◽  
Vol 1 (2) ◽  
pp. 84-88 ◽  
Author(s):  
Piotr Wranicz ◽  
Bente Brokstad Herlofson ◽  
Jan F. Evensen ◽  
Ulf E. Kongsgaard
Keyword(s):  
Head And Neck Cancer ◽  
Case Report ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Mouth Opening ◽  
Dose Fractionation ◽  
Therapeutic Effects ◽  
Limited Mouth Opening ◽  
Interincisal Distance

AbstractIntroductionTrismus, or limited mouth opening, is a well-known complication of head and neck cancer and its treatment. It may be caused by tumour infiltration into the masticatory muscles or by treatment like surgery and radiotherapy. A limited mouth opening may have a negative effect on nutrition, phonation, dental hygiene and treatment, and quality of life. The severity of this complication depends on the location of the tumour, the type of reconstruction, the total radiation dose, fractionation, and treatment techniques. If there is no intervention, these changes may be progressive and persist for life. There are no specific treatments for trismus. Current strategies emphasize prevention and, in instances of existing trismus, collaboration between health care professionals to establish pain control, prevent the progression of trismus, and restore function. The prevalence of trismus in head and neck cancer patients ranges from 5% to 38%. Despite numerous studies, reliable data on the aetiology of trismus and appropriate treatment for it are scarce.Case reportWe describe a patient with squamous cell carcinoma of the oropharynx who developed trismus after surgery and radiotherapy. A multidisciplinary treatment strategy including analgesics, regional blocks, hyperbaric oxygenation therapy, external dynamic bite opener and physiotherapy, increased the mouth opening from 5 mm to 22 mm, however, the patient still suffered from xerostomia and had problems with intake of solid food.Material and methodsA systematic literature search (starting January 1., 1980, and ending June 1., 2009) was performed to identify evidence-based interventions for the treatment of trismus in head and neck cancer patients. A total of 244 articles were identified from the databases. Of these, eight were excluded because of the absence of an English abstract and 214 were excluded because they were of marginal relevance to the inclusion criteria. The remaining 22 articles were evaluated independently by two experts using the Scottish Inter-collegiate Guidelines Network criteria for quality and evidence.ResultsThere were few studies of good methodological quality on this topic. Two systematic reviews and two RCTs were identified. The other reports involved cohorts, case series, and expert opinions.DiscussionEvidence in the form of clinical studies on therapeutic interventions is scarce. Numerous pharmacological treatment modalities have been described, but few are supported by the results of comparative trials involving control groups. Few studies have documented therapeutic effects for longer than a year. Better evidence was found for non-pharmacological methods, especially for physical therapy with passive and active stretching exercises, an important first-line strategy. The interincisal distance criterion for trismus varies between authors from 15 to 40 mm, which renders comparison between studies difficult. The absence of a standardized assessment protocol may also have contributed to variation between studies. An interincisal distance of 35 mm has been proposed as a definition of trismus. Explicit and precise treatment algorithms could not be established based on the available literature. However, a coordinated multidisciplinary approach in order to estimate and understand patient dysfunction is recommended; a systematic treatment plan should result in good symptom control and patient care. Prevention of trismus is more desirable than treatment for trismus.

Variation in repeated mouth-opening measurements in head and neck cancer patients with and without trismus

2009 ◽  
Vol 38 (1) ◽  
pp. 26-30 ◽  
Author(s):  
H. Jager-Wittenaar ◽  
P.U. Dijkstra ◽  
A. Vissink ◽  
R.P. van Oort ◽  
J.L.N. Roodenburg
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Mouth Opening

scholarly journals Emergency percutaneous tracheostomy in two cancer patients with difficult airway: An alternative to cricothyroidotomy?

2012 ◽  
Vol 01 (02) ◽  
pp. 90-92 ◽  
Author(s):  
Prashant Nasa ◽  
Akhilesh Singh ◽  
Deven Juneja ◽  
Nitin Garg ◽  
Omender Singh ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Difficult Airway ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Percutaneous Tracheostomy ◽  
Mouth Opening ◽  
Clinical Scenario ◽  
Life Saving ◽  
Neck Anatomy

AbstractInability to intubate and/or ventilate either due to distorted neck anatomy or restricted mouth opening is uncommon but potentially hazardous clinical scenario in head and neck cancer patients. Emergency cricothyroidotomy in such patients may provide a means of oxygenating the patient, but in practice has limitations and does not establish a definitive airway. We report 2 cases who had distorted face and neck anatomy in which percutaneous tracheostomy was done as an emergency life-saving procedure when other measures to obtain a definitive airway failed.

Acute and Chronic Depressive Disorders in Head and Neck Cancer Patients

2020 ◽  
pp. 27-33
Author(s):  
Leonid Bardenshtein ◽  
Valeriy Leontiev ◽  
Aleksey Drobyshev ◽  
Aleksandr Tsimbalistov ◽  
Nikolay Malginov ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Depressive Disorders ◽  
Clinical Symptoms ◽  
Depression Prevalence ◽  
Patient Category ◽  
Antipsychotic Drug Treatment ◽  
Timely Administration

The review focuses on depressive disorders in cancer patients. The article summarizes the findings of domestic and foreign studies on depression prevalence, clinical symptoms and treatment in head and neck cancer patients. Early detection of affective disorder and timely administration of antipsychotic drug treatment is shown to be important for this patient category.

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