2Department of Physical Medicine and Rehabilitation, Acıbadem International Hospital, İstanbul-Türkiye
3Department of Physical Medicine and Rehabilitation, Private Lüleburgaz Medical Center, Kırklareli-Türkiye
4Department of Biostatistics, Trakya University Faculty of Medicine, Edirne-Türkiye
5Department of Radiation Oncology, Hisar Intercontinental Hospital, İstanbul-Türkiye DOI : 10.5505/tjo.2024.4231 OBJECTIVE
Restricted mouth opening (trismus) is a common late effect of radiotherapy (RT) in patients (pts) with head and neck cancer. This study aims to reveal whether self-rehabilitation therapy, without any apparatus utilized after RT, has any therapeutic impact on trismus and mouth opening distance (MOD) in head and neck cancer pts.
METHODS
Fifty-three consecutive pts with squamous cell carcinoma of the head and neck treated with RT
± chemotherapy (ChT) were included in the study. An MOD of less than 35mm was accepted as
trismus. Self-rehabilitation exercises were started 3 months after RT and continued for 3 months.
The risk factors for trismus and MOD in relation to exercises were determined using univariate and
multivariate statistics.
RESULTS
The median age was 59 years (range: 31-84). Trismus was present in 41.5% of the group as a whole
(22 of 53 pts). The MOD for the entire group prior to physiotherapy was 37.33±7.83mm, and it was
38.75±7.66mm after physiotherapy (p=0.035). In multivariate analysis, concomitant ChT (OR=5.648,
95% CI: 1.043?30.596) and time passed after RT of more than 36 months (OR=8.238, 95% CI: 1.410?
48.136) were found to significantly increase the risk of trismus. However, when physiotherapy is used,
these risk factors lose their significance.
CONCLUSION
Self-rehabilitation without the use of any apparatus was discovered to be an effective treatment for trismus
after RT for the first time. We also discovered that self-rehabilitation improves the MOD values of
the entire patient population.