Criteria for trismus in head and neck oncology

Area of Science:

• Oncology
• Otorhinolaryngology
• Oral and Maxillofacial Surgery

Background:

• Trismus, characterized by limited mouth opening, is a common complication in head and neck cancer patients.
• Accurate functional assessment of trismus is crucial for timely intervention and management.

Purpose of the Study:

• To establish a precise functional cut-off point for diagnosing trismus in head and neck oncology.
• To correlate objective mouth opening measurements with subjective patient-reported functional impairments.

Main Methods:

• A cohort of 89 head and neck cancer patients (dentate, partially dentate, and edentulous) were evaluated.
• Mouth opening was measured, and the Mandibular Function Impairment Questionnaire (MFIQ) was administered.
• Receiver operating curve analysis was employed to determine the optimal cut-off point.

Main Results:

• A mouth opening of less than or equal to 35 mm demonstrated the highest accuracy (0.81) in predicting trismus.
• This cut-off yielded a sensitivity of 0.71 and a specificity of 0.98.
• Significant differences in perceived mandibular function were observed for cut-off points of 35 mm or less.

Conclusions:

• A mouth opening of less than or equal to 35 mm is identified as a functional cut-off point for trismus in head and neck oncology.
• This standardized measurement can improve the diagnostic accuracy and clinical management of trismus.
• Further subgroup analysis did not reveal consistent cut-off points for dentate, partially dentate, or edentulous patients.