Skip to main content
SpringerLink
Log in

Trismus in Head and Neck Cancer: Causes and Management

  • Chapter
  • First Online:
Dysphagia Management in Head and Neck Cancers

  • 1379 Accesses

Abstract

Reduced mobility of the mandible known as trismus is a phenomenon frequently seen in head and neck (H&N) cancer patients and patients with temporomandibular disorders [1–3]. Although numerous advancements have occurred in head and neck oncology practice during the past few decades, survival has not improved significantly. Currently, there is a need for clinical trials that focus not only on survival but also on the patient’s experience and health-related quality of life.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 139.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 229.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 249.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Pauli N, Johnson J, Finizia C, Andréll P. The incidence of trismus and long-term impact on health-related quality of life in patients with head and neck cancer. Acta Oncol. 2013;52:1137–45.

    Article  Google Scholar 

  2. Johnson J, van As-Brooks CJ, Fagerberg-Mohlin B, Finizia C. Trismus in head and neck cancer patients in Sweden: incidence and risk factors. Med Sci Monit. 2010;16:CR278–82.

    PubMed  Google Scholar 

  3. Manfredini D. Current concepts on temporomandibular disorders. London: Quintessence; 2010.

    Google Scholar 

  4. Dijkstra P, Huisman P, Roodenburg J. Criteria for trismus in head and neck oncology. Int J Oral Maxillofac Surg. 2006;35:337–42.

    Article  CAS  Google Scholar 

  5. Scott B, Butterworth C, Lowe D, Rogers SN. Factors associated with restricted mouth opening and its relationship to health-related quality of life in patients attending a maxillofacial oncology clinic. Oral Oncol. 2008;44:430–8.

    Article  CAS  Google Scholar 

  6. D'Cruz AK, Vaish R, Kapre N, et al. Elective versus therapeutic neck dissection in node-negative oral cancer. N Engl J Med. 2015;373(6):521–9.

    Article  CAS  Google Scholar 

  7. Bernier J, Cooper JS. Chemoradiation after surgery for high-risk head and neck cancer patients: how strong is the evidence? Oncologist. 2005;10:215–24.

    Article  Google Scholar 

  8. Bensadoun RJ, Riesenbeck D, Lockhart PB, Elting LS, Spijkervet FK, Brennan MT. A systematic review of trismus induced by cancer therapies in head and neck cancer patients. Support Care Cancer. 2010;18:1033–8.

    Article  Google Scholar 

  9. Louise Kent M, Brennan MT, Noll JL, et al. Radiation-induced trismus in head and neck cancer patients. Support Care Cancer. 2008;16:305–9.

    Article  CAS  Google Scholar 

  10. Overgaard J, Hansen HS, Specht L, et al. Five compared with six fractions per week of conventional radiotherapy of squamous- cell carcinoma of head and neck: DAHANCA 6 and seven randomised controlled trial. Lancet. 2003;362:933–40.

    Article  Google Scholar 

  11. Teguh DN, Levendag PC, Voet P, et al. Trismus in patients with oropharyngeal cancer: relationship with dose in structures of mastication apparatus. Head Neck. 2008;30:622–30.

    Article  Google Scholar 

  12. Hoffmann TK. Systemic therapy strategies for head-neck carcinomas: current status. GMS Curr Top Otorhinolaryngol Head Neck Surg. 2012;11:Doc03.

    PubMed  PubMed Central  Google Scholar 

  13. Agulnik M. New approaches to EGFR inhibition for locally advanced or metastatic squamous cell carcinoma of the head and neck (SCCHN). Med Oncol. 2012;29:2481–91.

    Article  CAS  Google Scholar 

  14. Scott B, D'Souza J, Perinparajah N, Lowe D, Rogers SN. Longitudinal evaluation of restricted mouth opening (trismus) in patients following primary surgery for oral and oropharyngeal squamous cell carcinoma. Br J Oral Maxillofac Surg. 2011;49:106–11.

    Article  CAS  Google Scholar 

  15. Buchbinder D, Currivan RB, Kaplan AJ, Urken ML. Mobilization regimens for the prevention of jaw hypomobility in the radiated patient: a comparison of three techniques. J Oral Maxillofac Surg. 1993;51:863–7.

    Article  CAS  Google Scholar 

  16. Grandi G, Silva ML, Streit C, Wagner JC. A mobilization regimen to prevent mandibular hypomobility in irradiated patients: an analysis and comparison of two techniques. Med Oral Patol Oral Cir Bucal. 2007;12:E105–9.

    PubMed  Google Scholar 

  17. Cohen EG, Deschler DG, Walsh K, Hayden RE. Early use of a mechanical stretching device to improve mandibular mobility after composite resection: a pilot study. Arch Phys Med Rehabil. 2005;86:1416–9.

    Article  Google Scholar 

  18. Barañano CF, Rosenthal EL, Morgan BA, McColloch NL, Magnuson JS. Dynasplint for the management of trismus after treatment of upper aerodigestive tract cancer: a retrospective study. Ear Nose Throat J. 2011;90(12):584–90.

    PubMed  Google Scholar 

  19. Kamstra JI, Reintsema H, Roodenburg JL, Dijkstra PU. Dynasplint Trismus system exercises for trismus secondary to head and neck cancer: a prospective explorative study. Support Care Cancer. 2016;24(8):3315–23.

    Article  Google Scholar 

  20. Shulman DH, Shipman B, Willis FB. Treating trismus with dynamic splinting: a cohort, case series. Adv Ther. 2008;25:9–16.

    Article  Google Scholar 

  21. Stubblefield MD, Manfield L, Riedel ER. A preliminary report on the efficacy of a dynamic jaw opening device (Dyna splint trismus system) as part of the multimodal treatment of trismus in patients with head and neck cancer. Arch Phys Med Rehabil. 2010;91:1278–82.

    Article  Google Scholar 

  22. Brown KE. Dynamic opening device for mandibular trismus. J Prosthet Dent. 1968;20:438–42.

    Article  CAS  Google Scholar 

  23. Dijkstra PU, Kropmans TJ, Tamminga RY. Modified use of a dynamic bite opener--treatment and prevention of trismus in a child with head and neck cancer: a case report. Cranio. 1992;10:327–9.

    Article  CAS  Google Scholar 

  24. Brunello DL, Mandikos MN. The use of a dynamic opening device in the treatment of radiation induced trismus. Aust Prosthodont J. 1995;9:45–8.

    CAS  PubMed  Google Scholar 

  25. Dijkstra P, Sterken M, Pater R, Spijkervet F, Roodenburg J. Exercise therapy for trismus in head and neck cancer. Oral Oncol. 2007;43:389–94.

    Article  CAS  Google Scholar 

  26. Kamstra JI, Roodenburg JL, Beurskens CH, Reintsema H, Dijkstra PU. TheraBite exercises to treat trismus secondary to head and neck cancer. Support Care Cancer. 2013;21:951–7.

    Article  Google Scholar 

  27. Chua DT, Lo C, Yuen J, Foo YC. A pilot study of pentoxifylline in the treatment of radiation-induced trismus. Am J Clin Oncol. 2001;24:366–9.

    Article  CAS  Google Scholar 

  28. Hartl DM, Cohen M, Julieron M, Marandas P, Janot F, Bourhis J. Botulinum toxin for radiation-induced facial pain and trismus. Otolaryngol Head Neck Surg. 2008;138:459–63.

    Article  Google Scholar 

  29. King GE, Scheetz J, Jacob RF, Martin JW. Electrotherapy and hyperbaric oxygen promising treatments for postradiation complications. J Prosthet Dent. 1989;62:331–4.

    Article  CAS  Google Scholar 

  30. Teguh DN, Levendag PC, Noever I, et al. Early hyperbaric oxygen therapy for reducing radiotherapy side effects: early results of a randomized trial in oropharyngeal and nasopharyngeal cancer. Int J Radiat Oncol Biol Phys. 2009;75:711–6.

    Article  Google Scholar 

  31. Bhrany AD, Izzard M, Wood AJ, Futran ND. Coronoidectomy for the treatment of trismus in head and neck cancer patients. Laryngoscope. 2007;117:1952–6.

    Article  Google Scholar 

  32. Kelsey CR, Jackson L, Langdon S, et al. A polymorphism within the promoter of the TGFb1 gene is associated with radiation sensitivity using an objective radiologic endpoint. Int J Radiat Oncol Biol Phys. 2012;82:247–55.

    Article  Google Scholar 

  33. Ghazali N, Shaw RJ, Rogers SN, Risk JM. Genomic determinants of normal tissue toxicity after radiotherapy for head and neck malignancy: a systematic review. Oral Oncol. 2012;48:1090–100.

    Article  Google Scholar 

  34. Brown JS, Blackburn TK, Woolgar JA, et al. A comparison of outcomes for patients with oral squamous cell carcinoma at intermediate risk of recurrence treated by surgery alone or with postoperative radiotherapy. Oral Oncol. 2007;43:764–73.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Head and Neck Surgery and Oncology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India

    Adharsh Anand & Deepak Balasubramanian

  2. Department of Prosthodontics, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India

    Anil Mathew

Authors
  1. Adharsh Anand
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Anil Mathew
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Deepak Balasubramanian
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Head and Neck Surgery and Oncology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, India

    Krishnakumar Thankappan

  2. Department of Head and Neck Surgery and Oncology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, India

    Subramania Iyer

  3. Department of Laryngology, Kerala Institute of Medical Sciences, Thiruvananthapuram and Dysphagia Unit, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, India

    Jayakumar R Menon

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer Nature Singapore Pte Ltd.

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Anand, A., Mathew, A., Balasubramanian, D. (2018). Trismus in Head and Neck Cancer: Causes and Management. In: Thankappan, K., Iyer, S., Menon, J. (eds) Dysphagia Management in Head and Neck Cancers. Springer, Singapore. https://doi.org/10.1007/978-981-10-8282-5_15

Download citation

  • DOI: https://doi.org/10.1007/978-981-10-8282-5_15

  • Published:

  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-10-8281-8

  • Online ISBN: 978-981-10-8282-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation