Current Perspective in the Evaluation and Treatment of Trismus

Hui-Ching Chuang ； Ming-Hsien Tsai ； Kun-Lin Yang

《International Journal of Head and Neck Science》 6卷2期 (2022/06) Pp. 57-71

https://doi.org/10.6696/IJHNS.202206_6(2).0002

摘要

Background: Trismus is prevalent among patients with a history of betel nut chewing or those who have had surgery or radiation for oral/oropharyngeal cancer. Clinically, a maximal interincisal opening (MIO) of less than 3.5 cm is defined as trismus, which causes problems in oral intake, difficulty in examining oral mucosa, and issues in maintaining dental hygiene. Eventually, it leads to a worse quality of life. Methods: A literature review was performed. Results: The mechanisms of trismus are heterogeneous, including the decreased compliance of oral mucosa, tumor involving the masticator space, ankylosis of temporomandibular joints, or in combination. There are two types of trismus, namely, pretreatment and posttreatment trismus. Trismus related to oral submucosal fibrosis and malignant tumor invading the masticator space are the common types of pretreatment trismus. Posttreatment trismus includes radiation- or surgery-induced trismus. Regarding the evaluation of trismus, there is direct measurements of MIO available. In addition, Mandibular Function Impairment Questionnaire, Performance Status Scale for Head and Neck Cancer Patients, Gothenburg Trismus Questionnaire, and Liverpool Oral Rehabilitation Questionnaire V3 are published in the literature. Conclusions: Surgical correction, oral rehabilitation, or both are the common ways to correct trismus, but the treatment results are heterogeneous because different mechanisms are involved in the development of this condition. The goal to have MIO over 3.5 cm is not easy to achieve if the initial presentation is severe.

關鍵字

trismus ； oral rehabilitation ； oral submucosal fibrosis ； nasolabial flap ； oral cancer