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Updated: Apr 1, 2026

Surgical Correction for Pediatric Epiblepharon and Trichiasis
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Surgery for extra-articular trismus: a systematic review.

M A Bouman1, P U Dijkstra2, H Reintsema3

  • 1University of Groningen, University Medical Center Groningen, Department of Plastic Surgery, Hanzeplein 1, P.O. Box 30.001, 9700 RB, Groningen, the Netherlands.

The British Journal of Oral & Maxillofacial Surgery
|October 13, 2015
PubMed
Summary

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Surgical operations can improve mouth opening for patients with extra-articular trismus, a condition often caused by cancer or oral submucous fibrosis. However, the evidence quality is moderate, indicating a need for more research on these interventions.

Area of Science:

  • Oral and Maxillofacial Surgery
  • Reconstructive Surgery
  • Systematic Review and Meta-Analysis

Background:

  • Extra-articular trismus, often resulting from cancer, its treatment, oral submucous fibrosis, or noma, significantly impairs mouth opening.
  • Limited evidence exists on the efficacy of surgical interventions for improving mouth opening in these patients.

Purpose of the Study:

  • To systematically review and identify surgical operations used to improve mouth opening in patients with extra-articular trismus.
  • To evaluate the effectiveness of these surgical interventions.

Main Methods:

  • Systematic search of electronic databases (PubMed, Embase, Cinahl, Cochrane).
  • Inclusion and quality assessment of 32 studies involving 651 patients.
  • Data extraction and meta-analysis to determine the impact on mouth opening.
Keywords:
Head and neck cancerNomaOral submucous fibrosisOral surgical proceduresReconstructive surgical proceduresSurgical flapsTreatment outcomeTrismus

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Main Results:

  • Surgical operations led to a weighted mean increase in mouth opening of 19.3 mm.
  • No single operation demonstrated superiority in improving mouth opening.
  • The quality of included studies and reporting was generally low.

Conclusions:

  • Surgical interventions are effective in improving mouth opening for extra-articular trismus.
  • The current evidence supporting these operations is of moderate quality.
  • Further high-quality research is necessary to optimize treatment strategies.