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Retrospective study on the predictive factors in chronic trismus.
M Smeets1, J Van Dessel1, T-M Croonenborghs1
1Oral and Maxillofacial Surgery, University Hospitals Leuven and OMFS-IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium.
The British Journal of Oral & Maxillofacial Surgery
|December 13, 2021
Summary
Masticatory muscle invasion is a key predictor of chronic trismus after head and neck cancer treatment. This finding helps identify patients at higher risk for this debilitating complication.
Area of Science:
- Oncology
- Oral and Maxillofacial Surgery
- Head and Neck Cancer Treatment
Background:
- Trismus is a debilitating complication of head and neck cancer treatment.
- It is often resistant to therapy, impacting oral function.
- Predicting chronic trismus is crucial for patient management.
Purpose of the Study:
- To identify primary tumor variables that predict chronic trismus.
- To assess the relationship between tumor characteristics and trismus development.
- To understand factors contributing to long-term mouth opening limitations.
Main Methods:
- Retrospective analysis of an oncological database.
- Inclusion of tumor-related, surgical, and oral functional variables.
- Logistic regression and mediational analysis to assess predictive factors for chronic trismus (mouth opening < 35 mm, >1 year post-treatment).
Main Results:
- Chronic trismus was observed in 13 out of 52 patients.
- Increased prevalence of trismus correlated with higher clinical T classification (p < 0.01).
- Tumor location (maxilla, retromolar trigone), adjuvant radiotherapy, and masticatory muscle invasion (p ≤ 0.02) were significant factors.
- Radiotherapy impacted T classification, and T classification related to muscle invasion.
Conclusions:
- Masticatory muscle invasion is a primary predictive factor for chronic trismus.
- While radiotherapy and T classification are known risks, muscle invasion warrants significant consideration.
- Understanding these predictors can improve management of post-treatment trismus.
