Ear, Nose and Throat Disorders

Aim: Aim of this study is to investigate the long-term effects of structured trismus intervention in patients with head and neck cancer (HNC) and trismus in terms of trismus related symptoms and health related quality of life (HRQL) and mouth opening. Material & Methods: Patients with HNC to receive radiotherap ±chemotherapy (n=50) were included in this prospective study along with a matched control group. The intervention group received a 10 weeks structured exercise with a jaw mobilizing device.

Patients were assessed before and after trismus exercise intervention and at a two-year follow-up. Primary endpoint was maximum inter-incisal opening (MIO) and secondary endpoints included trismus-related symptoms and HRQL assessed with patient-reported outcome (PRO)-instruments European Organization for Research and Treatment of Cancer Core Questionnaire (EORTC QLQ-C30) and the related HNC-specific module the EORTC Head & Neck Questionnaire (EORTC QLQ-H&N35) and Gothenburg Trismus Questionnaire (GTQ). Results: At the two-year follow-up, the intervention group had a higher MIO compared to the control group (40.5 mm and 34.3 mm, respectively), which was statistically significant. The intervention group also reported less jaw-related problems according to the GTQ and higher functioning as measured by EORTC QLQ-C30 and QLQ-H&N35 compared to the control group. Conclusion: A positive persistent effect of exercise intervention for trismus in HNC patients was found with regard to trismusrelated symptoms, MIO and HRQL. Exercise intervention is important in long-term treatment of radiation-induced trismus in HNC patients. The trismus-specific questionnaire, GTQ, is a valuable tool for observing and evaluating trismus over time.