Limited mouth opening after primary therapy of head and neck cancer.
OBJECTIVE
Patients after surgery and radiation/chemoradiation for treatment of head and neck cancer often suffer from oral complications. These problems may be caused by surgery and radiation. Patients complain, for example, of swallowing problems and limited mouth opening (trismus).


METHODS
The maximal interincisal mouth opening (MIO) was measured in patients treated with surgery and radiation/chemoradiation for head and neck cancer at the Department of Otorhinolaryngology at the University of Rostock. These patients also completed a 20-item questionnaire concerning nutritional, sensual, and speech disorders and pain.


RESULTS
One hundred one patients (16 female and 85 male) returned the questionnaire and were included in the study. About 50% of the patients had a limited mouth opening (<36 mm); patients with oropharyngeal cancer had a significant higher risk for trismus (p = .024) than patients with other head and neck cancers, especially compared to patients with laryngeal cancer (p = .013). The questionnaire showed that especially patients with oral cancer report about problems with opening the mouth (73%), eating (65%), drinking (73%), xerostomia (92%), speech disorders (68%), and voice (62%). Patients with laryngeal cancer only reported about problems with xerostomia (62%), speech (83%), and voice (90%), similar to patients with pharyngeal cancer.


CONCLUSIONS
About half of the patients who underwent primary treatment for oral and oropharyngeal cancer developed trismus and reported about problems with opening the mouth, eating, drinking, dry mouth, voice, and speech. Trismus has a negative impact on quality of life and should be a focus in the postoperative management of patients with oral and oropharyngeal cancer, and, if diagnosed, special treatment should be initialized.
Weber
Clemens
C
Department of Head and Neck Surgery, University Hospital Rostock Otto Körner, Doberaner Str. 137/139, 18057, Rostock, Germany. clemens.weber@med.uni-rostock.de
Dommerich
Steffen
S
Pau
Hans Wilhelm
HW
Kramp
Burkhard
B
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects; D003680:Deglutition Disorders / Q000209:etiology; D004326:Drinking / Q000502:physiology; D001068:Feeding and Eating Disorders / Q000209:etiology; D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000601:surgery; D007822:Laryngeal Neoplasms / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009055:Mouth / Q000503:physiopathology*; D009059:Mouth Diseases / Q000209:etiology*; D020360:Neoadjuvant Therapy / Q000009:adverse effects; D009959:Oropharyngeal Neoplasms / Q000601:surgery; D010146:Pain / Q000209:etiology; D011788:Quality of Life; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D012678:Sensation Disorders / Q000209:etiology; D013064:Speech Disorders / Q000209:etiology; D014313:Trismus / Q000209:etiology; D014832:Voice Disorders / Q000209:etiology; D014987:Xerostomia / Q000209:etiology