Temporomandibular disorder in head and neck cancer patients undergoing radiotherapy: Clinical findings and patient-reported symptoms

Head Neck. 2019 Oct;41(10):3570-3576. doi: 10.1002/hed.25878. Epub 2019 Jul 16.

Abstract

Background: The aim of this study was to investigate how common temporomandibular disorder (TMD) symptoms are among head and neck cancer (HNC) patients before and after oncological treatment.

Methods: Eighty-nine patients with HNC receiving radiotherapy were enrolled in the study. Patients were examined before radiotherapy and at 6 and 12 months after radiotherapy to evaluate the function and tenderness of the temporomandibular jaw and the muscles of mastication as well as the patient-reported symptoms.

Results: At 6 months after radiotherapy, there was a large increase in the number of patients reporting problems with opening their mouth, fatigue, stiffness, and pain of the jaw. Sixty-eight percent of the patients had symptoms of TMD before oncological treatment and 94% and 81% had symptoms at the 6- and 12-month follow-up, respectively.

Conclusion: The signs and symptoms of TMD escalate after radiotherapy, with symptoms peaking at 6 months after radiotherapy. Most commonly, patients suffer from restricted mouth opening, stiffness, fatigue, and pain of the jaw.

Keywords: head and neck cancer; radiotherapy; temporomandibular disorder; trismus.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / radiotherapy*
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Head and Neck Neoplasms / pathology
  • Head and Neck Neoplasms / radiotherapy*
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Invasiveness / pathology
  • Neoplasm Staging
  • Patient Reported Outcome Measures*
  • Radiotherapy, High-Energy / adverse effects*
  • Radiotherapy, High-Energy / methods
  • Retrospective Studies
  • Risk Assessment
  • Temporomandibular Joint Disorders / etiology*
  • Temporomandibular Joint Disorders / physiopathology
  • Time Factors
  • Trismus / etiology*
  • Trismus / physiopathology