Premium
Trismus in patients with oropharyngeal cancer: Relationship with dose in structures of mastication apparatus
Author(s) -
Teguh David N.,
Levendag Peter C.,
Voet Peter,
van der Est Henri,
Noever Inge,
de Kruijf Willy,
van Rooij Peter,
Schmitz Paul I. M.,
Heijmen Ben J.
Publication year - 2008
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.20760
Subject(s) - trismus , pterygoid muscles , masticatory force , medicine , mastication , head and neck cancer , masseter muscle , muscles of mastication , lateral pterygoid muscle , head and neck , dentistry , swallowing , orthodontics , temporomandibular joint , radiation therapy , surgery
Background Our aim was to assess the correlation between the radiation therapy (RT) dose to the mastication apparatus and trismus of oropharyngeal cancer patients. Methods Eighty‐one patients treated with RT were analyzed. The masseter, pterygoid, and temporalis muscles and the coronoid and condyl were delineated on axial CT slices. The mean dose in these structures was correlated with outcome of quality of life questionnaires. Results Fifty‐six (88%) patients responded; 16% of the patients scored grade 3/4 on the Head & Neck 35 “opening mouth” question. A significant correlation was observed between dose in masseter and pterygoid muscles and trismus ( p = .02). Conclusion Patients treated with brachytherapy received a lower dose in masticatory muscles. A steep dose‐effect relationship between mean dose in masseter muscle and pterygoid muscles and the probability of having trismus complaints was observed; with every additional 10 Gy to the pterygoid muscle, an increase of the probability of trismus of 24% was observed. © 2008 Wiley Periodicals, Inc. Head Neck, 2008