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Intraoral Coronoidotomy Treatment for Trismus due to Radiotherapy: A Case Report

Year 2009, Volume: 36 Issue: 2 - Volume: 36 Issue: 2, 103 - 107, 01.05.2009

Abstract

Trismus is defined as the tonic contraction ofthe muscles of mastication that can dramaticallyaffect quality of life in a variety of ways. Trismusoccurs in head and neck cancer patients as a resultof tumours in or around the region of masticatorymuscles or after radiotherapy treatment. It has beenknown that it occurs after radiotherapy treatmentin the ratio of %5-38. Treatment modalities for limited mouth opening include coronoidectomy,coronoidotomy and aggressive physical therapy alone orcombined.In this case report, intraoral coronoidotomytreatment of a patient with limited mouth openingdue to radiotherapy treatment for nasopharynxcancer is presented

References

  • Dijkstra PU, Kalk WW, Roodenburg JL. Trismus in head and neck oncology: a systematic review. Oral Oncol 2004; 40: 879-89.
  • Ichimura K, Tanaka T. Trismus in patients with malignant tumours in the head and neck. J Laryngol Otol 1993; 107: 1017-20.
  • Goldstein M, Maxymiw WG, Cummings BJ, Wood RE. The effects of antitumor irradiation on mandibular opening and mobility: a prospective study of 58 patients. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999; 88: 365-73.
  • Wang CJ, Huang EY, Hsu HC, Chen HC, Fang FM, Hsiung CY. The degree and time-course assessment of radiation-induced trismus occurring after radiotherapy for nasopharyngeal cancer. Laryngoscope 2005; 115:1458-60.
  • Vissink A, Burlage FR, Spijkervet FK, Jansma J, Coppes RP. Prevention and treatment of the consequences of head and neck radiotherapy. Crit Rev Oral Biol Med 2003; 14: 21325.
  • Goldstein M, Maxymiw WG, Cummings BJ, Wood RE. The effects of antitumor irradiation on mandibular opening and mobility: a prospective study of 58 patients. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999; 88:365-73.
  • Thomas F,Ozanne F,Mamella G,Wibault P, Eschwege F. Radiotherapy alone for oropharengeal carcinomas: the role of fraction size (2 Gy vs. 2.5 Gy) on local control and early and late complica- tions. Int J Radiat Oncol Biol Phys 1998; 15: 1097- 102.
  • Özyar E, Karakaya E, Yıldız F, Atahan L. Nazofarenks kanserli hastalarda geç yan etki olarak ortaya çıkan trismus gelişimine etkili faktörler. Türk Onkoloji Dergisi 2006; 21: 57-62.
  • Mertens R,Lassay L, Heimann G.: Combined treatment of NPC in ehil dren and adolescents con- cept of study, Klin Pediatr. Germany, 205(4), p241 - 8, Jul -Aug 1993
  • Wolden SL, Steinherz PG, Kraus DH, at al.: Improved long -term survival with combined moda- lity therapy for pediatric NPC
  • Fang FM, Chiu HC, Kuo WR, Wang CJ, Leung SW,Chen HC, et al. Health-releated quality of life for nasopharyngeal carcinoma patients with can- cer-free survival after treatment. Int J Radiat Oncol Biol Phys 2002; 53: 959-68.
  • Pow EH, McMillan AS, Leung WK, Kwong DL, Wong MC. Oral health condition in southern Chinese after radiotherapy for nasopharyn- geal carcinoma: extent and nature of the problem. Oral Dis 2003; 9: 196-202.
  • Schwarz E., Chiu GK, Leung WK. Oral health status of southern Chinese foloowing head and neck irradiation therapy: the impact of the target vo- lume Int J Radiat Oncol Biol Phys 1999; 45:47-52.
  • Hoppe RT, Goffinet DR, Bagshaw MA. Carcinoma of the nasopharynx. Eighteen years’ experience with megavoltage radiation therapy. Cancer 1976; 37: 2605-12.
  • Lee AW, Law SC, Ng SH, Chan DK.Poon Yf Foo W. Retrospective analysis ofnasopharyngeal carcinoma treated during 1976-1985 late complica- tions following megavoltage irradiation. Br J Radiol 1992; 65: 918-28.
  • Choi KN, Rotman M, Aziz H, Sohn CK Schulsinger A, Torres C.concomitans infusion cis- platin and hyperfractionated radiotherapy for locally advanced nasopharyngeal and paranasal sinus tumors. Int J Radiat Oncol Biol Phys 1997; 39: 823- 9.
  • Vissink A, Burlage FR, Spijkervet FK, Jansma J, Coppes RP. Prevention and treatment of the consequences of head and neck radiotherapy. crit rev Oral Biol Med 2003; 14: 213-25.
  • Goldstein M, Maxymiw WG, Cummings BJ, Wood RE. The effects of antitumor irradiation on mandibular opening and mobility: a prospective study of 58 patients. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999; 88: 365-73.
  • Buchbinder D, Currivan RB, Kaplan AJ, Urken ML. Mobilization regimens for the prevention of jaw hypomobility in the radiated patient: a com- parison of three techniques. J Oral Maxillofac Surg 1993; 51: 863-7.
  • Santos RB, Efeito do estimulo mastigatorio nas alteraçoes sialometricas, de abertura bucal e xerostomia em pacientes submetidos a radioterapia na regiao de cabeça e pescoço. PUCRS, 2003. Tese, Faculdade de Odontologia, Pontificia Universidade Catolica do Rio Grande do Sul 2003.
  • Dijkstra PU, Sterken MW, Pater R, Spijkervet FK, RoodenburgJL. Exercise therapy for trismus in head and neck cancer. Oral Oncol 2006; 43: 389.
  • Louise Kent M,Brennan MT,Noll JL, Fox PC, Burri SH, Hunter JC. Radiation in head and neck cancer patients-induced-trismus.Support Care Cancer 2008;16: 305-9.
  • Shulman DH, Shipman B, Willis FB.Treating trismus with dynamic splinting: A cohort, case series. Adv Ther 2008; 25:9-15.
  • Lennox AJ, Shafer JP, Hatcher M, Beil J, Funder SJ. Pilot study of impedance controlled microcurrent therapy for managing radiationin duced fibrozis head and neck cancer patients Int J Radiation Oncol Biol Phys 2002; 54: 23-34.
  • Chua DT, Lo C, Yuen J, Foo YC. A pilot study of pentoxifylline in the treatment of radiation trismus. Am J Clin Oncol 2001; 24: 366-9.
  • Gibbons AJ., Abulhoul S. Use of a Therabite appliance in the management of bilateral mandibular coronoid hyperplasia. Br. J. Oral Maxillofac Surg. 2007;45: 505–6.
  • Smyth AG., Wake MJ. Recurrent bilateral coronoid hyperplasia: an unusual case. Br J Oral Maxillofac Surg. 1994; 32:100–4.

Radyoterapiye bağlı gelişen trismusun koronoidotomi ile tedavisi: bir olgu sunumu

Year 2009, Volume: 36 Issue: 2 - Volume: 36 Issue: 2, 103 - 107, 01.05.2009

Abstract

Trismus; çiğneme kaslarının tonik kontraksiyonu olarak tanımlanan yaşam kalitesini negatifyönde etkileyen bir semptomdur.Baş ve boyunkanserli hastalarda tümörün kas içine yayılmasıylameydana geldiği gibi tedavi amaçlı uygulananradyoterapiye bağlı olarak da meydana gelebilmektedir. Yapılan çalışmalarda radyoterapi sonrası trismus oluşumu oranı % 5-38 olarak bildirilmektedir. Bu vakalarda trismusa bağlı sınırlı ağız açıklığınayönelik tedavi seçenekleri koronoidektomi, koronoidotomi ve yoğun fizyoterapi seçeneklerinden biriya da kombine kullanımlarını içermektedir

References

  • Dijkstra PU, Kalk WW, Roodenburg JL. Trismus in head and neck oncology: a systematic review. Oral Oncol 2004; 40: 879-89.
  • Ichimura K, Tanaka T. Trismus in patients with malignant tumours in the head and neck. J Laryngol Otol 1993; 107: 1017-20.
  • Goldstein M, Maxymiw WG, Cummings BJ, Wood RE. The effects of antitumor irradiation on mandibular opening and mobility: a prospective study of 58 patients. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999; 88: 365-73.
  • Wang CJ, Huang EY, Hsu HC, Chen HC, Fang FM, Hsiung CY. The degree and time-course assessment of radiation-induced trismus occurring after radiotherapy for nasopharyngeal cancer. Laryngoscope 2005; 115:1458-60.
  • Vissink A, Burlage FR, Spijkervet FK, Jansma J, Coppes RP. Prevention and treatment of the consequences of head and neck radiotherapy. Crit Rev Oral Biol Med 2003; 14: 21325.
  • Goldstein M, Maxymiw WG, Cummings BJ, Wood RE. The effects of antitumor irradiation on mandibular opening and mobility: a prospective study of 58 patients. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999; 88:365-73.
  • Thomas F,Ozanne F,Mamella G,Wibault P, Eschwege F. Radiotherapy alone for oropharengeal carcinomas: the role of fraction size (2 Gy vs. 2.5 Gy) on local control and early and late complica- tions. Int J Radiat Oncol Biol Phys 1998; 15: 1097- 102.
  • Özyar E, Karakaya E, Yıldız F, Atahan L. Nazofarenks kanserli hastalarda geç yan etki olarak ortaya çıkan trismus gelişimine etkili faktörler. Türk Onkoloji Dergisi 2006; 21: 57-62.
  • Mertens R,Lassay L, Heimann G.: Combined treatment of NPC in ehil dren and adolescents con- cept of study, Klin Pediatr. Germany, 205(4), p241 - 8, Jul -Aug 1993
  • Wolden SL, Steinherz PG, Kraus DH, at al.: Improved long -term survival with combined moda- lity therapy for pediatric NPC
  • Fang FM, Chiu HC, Kuo WR, Wang CJ, Leung SW,Chen HC, et al. Health-releated quality of life for nasopharyngeal carcinoma patients with can- cer-free survival after treatment. Int J Radiat Oncol Biol Phys 2002; 53: 959-68.
  • Pow EH, McMillan AS, Leung WK, Kwong DL, Wong MC. Oral health condition in southern Chinese after radiotherapy for nasopharyn- geal carcinoma: extent and nature of the problem. Oral Dis 2003; 9: 196-202.
  • Schwarz E., Chiu GK, Leung WK. Oral health status of southern Chinese foloowing head and neck irradiation therapy: the impact of the target vo- lume Int J Radiat Oncol Biol Phys 1999; 45:47-52.
  • Hoppe RT, Goffinet DR, Bagshaw MA. Carcinoma of the nasopharynx. Eighteen years’ experience with megavoltage radiation therapy. Cancer 1976; 37: 2605-12.
  • Lee AW, Law SC, Ng SH, Chan DK.Poon Yf Foo W. Retrospective analysis ofnasopharyngeal carcinoma treated during 1976-1985 late complica- tions following megavoltage irradiation. Br J Radiol 1992; 65: 918-28.
  • Choi KN, Rotman M, Aziz H, Sohn CK Schulsinger A, Torres C.concomitans infusion cis- platin and hyperfractionated radiotherapy for locally advanced nasopharyngeal and paranasal sinus tumors. Int J Radiat Oncol Biol Phys 1997; 39: 823- 9.
  • Vissink A, Burlage FR, Spijkervet FK, Jansma J, Coppes RP. Prevention and treatment of the consequences of head and neck radiotherapy. crit rev Oral Biol Med 2003; 14: 213-25.
  • Goldstein M, Maxymiw WG, Cummings BJ, Wood RE. The effects of antitumor irradiation on mandibular opening and mobility: a prospective study of 58 patients. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999; 88: 365-73.
  • Buchbinder D, Currivan RB, Kaplan AJ, Urken ML. Mobilization regimens for the prevention of jaw hypomobility in the radiated patient: a com- parison of three techniques. J Oral Maxillofac Surg 1993; 51: 863-7.
  • Santos RB, Efeito do estimulo mastigatorio nas alteraçoes sialometricas, de abertura bucal e xerostomia em pacientes submetidos a radioterapia na regiao de cabeça e pescoço. PUCRS, 2003. Tese, Faculdade de Odontologia, Pontificia Universidade Catolica do Rio Grande do Sul 2003.
  • Dijkstra PU, Sterken MW, Pater R, Spijkervet FK, RoodenburgJL. Exercise therapy for trismus in head and neck cancer. Oral Oncol 2006; 43: 389.
  • Louise Kent M,Brennan MT,Noll JL, Fox PC, Burri SH, Hunter JC. Radiation in head and neck cancer patients-induced-trismus.Support Care Cancer 2008;16: 305-9.
  • Shulman DH, Shipman B, Willis FB.Treating trismus with dynamic splinting: A cohort, case series. Adv Ther 2008; 25:9-15.
  • Lennox AJ, Shafer JP, Hatcher M, Beil J, Funder SJ. Pilot study of impedance controlled microcurrent therapy for managing radiationin duced fibrozis head and neck cancer patients Int J Radiation Oncol Biol Phys 2002; 54: 23-34.
  • Chua DT, Lo C, Yuen J, Foo YC. A pilot study of pentoxifylline in the treatment of radiation trismus. Am J Clin Oncol 2001; 24: 366-9.
  • Gibbons AJ., Abulhoul S. Use of a Therabite appliance in the management of bilateral mandibular coronoid hyperplasia. Br. J. Oral Maxillofac Surg. 2007;45: 505–6.
  • Smyth AG., Wake MJ. Recurrent bilateral coronoid hyperplasia: an unusual case. Br J Oral Maxillofac Surg. 1994; 32:100–4.
There are 27 citations in total.

Details

Primary Language Turkish
Journal Section Case Report
Authors

Ayşegül M. Tüzüner Öncül This is me

Zehra Fırtına This is me

Seda Deniz Güner This is me

Duygu Yazıcıoğlu This is me

Reha Kişnişçi This is me

Publication Date May 1, 2009
Published in Issue Year 2009 Volume: 36 Issue: 2 - Volume: 36 Issue: 2

Cite

Vancouver Tüzüner Öncül AM, Fırtına Z, Güner SD, Yazıcıoğlu D, Kişnişçi R. Radyoterapiye bağlı gelişen trismusun koronoidotomi ile tedavisi: bir olgu sunumu. EADS. 2009;36(2):103-7.