title: Postradiation trismus and its impact on quality of life in patients with head and neck cancer.
abstract: OBJECTIVE
  The aims of this study were to investigate the following in patients with head and neck cancer (HNC): (1) factors related to trismus that predict the development of trismus, (2) factors affecting quality of life and measurements of these factors, and (3) comparison of these findings in patients with and without trismus to evaluate the effects of trismus on quality of life.
  
  
  METHODS
  This cross-sectional study included the questionnaires: the Hospital Anxiety and Depression Scale (HADS) - Depression Subscale, the Chewing Function Questionnaire (CFQ), and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire - Head and Neck Cancer Module (EORTC QLQ-HN35). A scaled ruler was used to measure maximal intercisal opening (MIO).
  
  
  RESULTS
  Of the 104 patients in the study, 8.7% had clinical depression. The average MIO was 35.81 mm, and 47.1% of patients had trismus. Moderate levels of chewing dysfunction with regard to different types of food were noted. Lower body mass index, chemoradiotherapy treatment, longer time since treatment completion, and higher radiation dose were significantly associated with trismus. Such patients had significantly lower head and neck-specific quality of life in terms of social contact, sexuality, teeth, mouth opening, dry mouth, feeling ill, nutritional supplement, and weight loss.
  
  
  CONCLUSIONS
  Patients with trismus should be provided mouth opening exercises after treatment and programs to improve trismus and quality of life.
authors.affiliation: Department of Nursing, China Medical University Beigang Hospital, Yunlin, Taiwan; and School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.
authors.forename: Li-Yun
authors.initials: LY
authors.lastname: Lee
authors.affiliation: Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan; Head and Neck Oncology Group, Chang Gung Medical Foundation, Chang Gung Memorial Hospital at LinKou, Taoyuan, Taiwan. Electronic address: shuching@gw.cgust.edu.tw.
authors.forename: Shu-Ching
authors.initials: SC
authors.lastname: Chen
authors.affiliation: Department of Radiation Oncology, Chang Gung Medical Foundation, Chang Gung Memorial Hospital at Chiayi; and College of Medicine, Chang Gung University, Chiayi, Taiwan; Head and Neck Oncology Group, Chang Gung Medical Foundation, Chang Gung Memorial Hospital at Chaiyi, Chaiyi, Taiwan.
authors.forename: Wen-Cheng
authors.initials: WC
authors.lastname: Chen
authors.affiliation: Head and Neck Oncology Group, Chang Gung Medical Foundation, Chang Gung Memorial Hospital at LinKou, Taoyuan, Taiwan; Department of Radiation Oncology, Chang Gung Medical Foundation, Chang Gung Memorial Hospital at LinKou; and Graduate Institute of Clinical Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Bing-Shen
authors.initials: BS
authors.lastname: Huang
authors.affiliation: Head and Neck Oncology Group, Chang Gung Medical Foundation, Chang Gung Memorial Hospital at LinKou, Taoyuan, Taiwan; Department of Radiation Oncology, Chang Gung Medical Foundation, Chang Gung Memorial Hospital at LinKou; and Graduate Institute of Clinical Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Chien-Yu
authors.initials: CY
authors.lastname: Lin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003863:Depression / Q000209:etiology*; D005260:Female; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008409:Mastication / Q000528:radiation effects*; D008875:Middle Aged; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013624:Taiwan; D014313:Trismus / Q000209:etiology*