Article

OBJECTIVE: To examine the effectiveness of a dynamic jaw opening device as part
of a multimodal treatment strategy for trismus in patients with head and neck
cancer. DESIGN: Retrospective cohort study. SETTING: Tertiary care cancer center.
PARTICIPANTS: Patients with head and neck cancer and trismus (N=20).
INTERVENTION: All patients underwent assessment by a board-certified physiatrist
and were referred to physical therapy for delivery of the DTS and instructed to
progress use of the DTS to 30 minutes 3 times a day. Additional modalities for
the treatment of trismus including pain medications and botulinum toxin
injections were prescribed as clinically indicated. MAIN OUTCOME MEASURES: Change
in maximal interincisal distance (MID) as documented in the medical record.
RESULTS: The use of the DTS as part of multimodal therapy including physical
therapy, pain medications, and botulinum toxin injections as deemed clinically
appropriate resulted in an overall improvement of the MID from 16.5mm to 23.5mm
(P<.001). Patients who could comply with the treatment recommendations for DTS
treatment did better than those who could not, with an improvement of the MID
from 16 mm to 27 mm (P<.001) versus 17 mm to 22 mm (P=.88). CONCLUSIONS: The DTS
is a safe and effective component of a multimodal strategy for improving trismus
associated with head and neck cancer and its treatment. Further investigation is
needed to determine the relative efficacy of the treatment modalities available
for trismus including physical therapy and other jaw stretching devices.

Langue : ANGLAIS