Effect of the Radiation therapy on Temporomandibular joint and its function: a prospective study
Aia Naksho1,2 , Firoozeh Samim1,2 , Nour Karra2
1Faculty of Dental Medicine and Oral Health Science, 六合彩开奖结果, Montreal, Quebec, Canada 2Oral medicine Clinic, Royal Victoria Hospital glenn site, Montreal, Quebec, Canada
Abstract Background: Head and neck cancer can be treated using multiple modalities such as chemotherapy, surgery, and radiation therapy. While radiotherapy is considered a primary treatment for most head and neck cancers, it can cause debilitating side effects such as hyposalivation, mucositis, and limitation in the mouth opening. These side effects of radiation depend on several risk factors including the radiation dosage, tumor size and location, and the existence of temporomandibular disorders (TMD) in patients prior to their cancer diagnosis. Unfortunately, the quality of life of head and neck cancer patients drops dramatically due to TMD disorder symptoms, such as pain and limitation in mouth opening. The development of TMD disorders and hypofunction in oncology patients is most likely due to the fibrosis of the muscles of mastication and temporomandibular joint.
Aim: The primary aim of this study is to determine the prevalence of TMD symptoms in head and neck cancer patients including SCC of oral cavity, and oropharyngeal areas. In addition, this study is aimed to identify the risk factors in developing such consequences.
Methods: The initial phase of this project was a comprehensive literature review. The second phase of the study was to prospectively follow up 40 newly diagnosed patients with Head and neck cancer who were referred to the oral oncology clinic located at Royal Victoria hospital (Glenn site) prior to the initiation of radiation therapy. Patient with prior radiation therapy or surgical therapy with limitation in the mouth opening consequently were excluded. The examinations were performed prior, mid- treatment and after radiotherapy in 3-months and 6-months follow up. Validated DC/TMD criteria and Examination Form was used to record our findings. All examination was performed by a specialist or a dentist or resident who have been calibrated. Inter and intra-examination liability was performed.
Statistical analysis: All the data gathered will be transferred to SPSS for statistical analysis. Determined from type of study variables, test to be utilized will be chosen. Based on existing literature, we intend to represent frequency distribution, mean and median calculations followed by comparative analysis of study variables.
Significant of the study: Although current literature shows the prevalence of TMD disorders prior to a patient's cancer diagnosis may increase the risk of limitation in the jaw movement after completing radiotherapy. Future prospective studies are essential to identify potential sociodemographic risk factors and effective preventive strategies to avoid radiotherapy complications in both the short and long term. An increase in mouth opening is essential to improve quality of life, speech, ensure adequate nutrition, and decrease depression rates among head and neck cancer survivor patients.
Results: Patients recruitment and data collection is ongoing. Data analysis and research discussion and conclusions is expected to be completed.
Conclusion: Patients recruitment and data collection is ongoing. Data analysis and research discussion and conclusions is expected to be completed.