Early use of a mechanical stretching device to improve mandibular mobility after composite resection: a pilot study.
OBJECTIVE
To evaluate the use of a mechanical stretching device, the Therabite, for the early postoperative management of trismus in select patients.


METHODS
Prospective series of consecutive head and neck cancer patients.


METHODS
Academic, tertiary referral center.


METHODS
Seven patients with oropharyngeal carcinoma who underwent resection and radial forearm flap reconstruction. Five had midline mandibulotomy procedures for exposure. Six had radiation therapy (2 pre, 4 post).


METHODS
Patients were given a Therabite mechanical jaw mobilization device, were instructed in its proper use, and began using it within 6 weeks postoperatively.


METHODS
Maximal interincisor opening (MIO) was measured at the beginning of use and at the most recent postoperative visit. A 5-question self-assessment telephone survey was administered on study completion.


RESULTS
The average MIO was 30 mm (range, 21-38 mm) at the beginning of the study and 40 mm (range, 30-57 mm) at the last visit. Average gain in MIO was 10 mm (range, 1-21 mm). Four of 5 assessable patients had minimal or no limitation on overall quality of life relative to jaw opening. No complications were associated with use of the device. Two patients could not be located for follow-up.


CONCLUSIONS
The Therabite mechanical stretching device is effective and safe for the management of trismus in a select group of head and neck cancer patients after extensive ablation and complex reconstruction. Specifically, there were no adverse effects in the 5 patients who had undergone midline mandibulotomy.
Department of Otolaryngology-Head and Neck Surgery, University of Medicine and Dentistry of New Jersey, Newark, NJ, USA.
Erik G
EG
Cohen
Daniel G
DG
Deschler
Kathleen
K
Walsh
Richard E
RE
Hayden
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008334:Mandible / Q000601:surgery*; D008349:Manipulation, Orthopedic / Q000295:instrumentation*; D008875:Middle Aged; D009959:Oropharyngeal Neoplasms / Q000601:surgery*; D010865:Pilot Projects; D011183:Postoperative Complications; D011446:Prospective Studies; D013524:Surgical Flaps; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014313:Trismus / Q000209:etiology / Q000534:rehabilitation*