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Evaluation of New Treatment in Patients Suffering from Trismus following Radiotherapy

Objectives: Trismus (maximum interincisal opening less than 36 mm) impacts on activities of daily living and adversely affects patient quality of life (QoL). This study aims to investigate the effectiveness of mouth-opening tools in the rehabilitation of trismus in patients with head and neck cancer as well as any improvement in patients’ health-related quality of life (HRQL). Methods: Thirteen study patients suffering from trismus following radiotherapeutic treatment for head and neck cancer were identified in 2010 at Sahlgrenska University Hospital, Gothenburg, Sweden. An additional 13 patients constituted a control group. The study patients were enrolled in a mouth opening training program in contrast to the control patients who did not receive any systematic training. All patients reported HRQL via validated questionnaires including EORTC C30, EORTC H&N35, and S-SECEL. Results: Twelve months after completion of the mouth opening training program, none of the study patients demonstrated trismus, whereas 62% of patients in the control group suffered from trismus. The study cohort reported a clinically significant improvement after mouth opening exercises with regard to social function and global QoL. No clinically significant change was observed with regard to these scales in the control group. Conclusions: This study indicates a positive relationship between systematic mouth-opening training, reduction of trismus, and improved QoL. Systematic mouth opening exercises should be implemented as standard treatment for cancer patients demonstrating trismus once larger trials have confirmed the results from this study.