Annals of Rehabilitation Medicine

"Trismus"

Original Article

Effects of Ultrasound, Laser and Exercises on Temporomandibular Joint Pain and Trismus Following Head and Neck Cancer: Hany Mohamed Elgohary, Hadaya Mosaad Eladl, Ashraf Hassan Soliman, Elsadat Saad Soliman; Ann Rehabil Med 2018;42(6):846-853. Published online December 28, 2018; DOI: https://doi.org/10.5535/arm.2018.42.6.846

Abstract
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Objective
To compare the effects of low intensity ultrasound (LIUS), traditional exercise therapy (TET), low level laser therapy (LLLT) and TET on temporomandibular joint (TMJ) pain and trismus following recovery from head and neck cancer (HNC).
Methods
Sixty participants following, who had experienced HNC, were randomly allocated to three groups of 20 people each. Each group received different therapy. Group A received LIUS and TET; group B received LLLT and TET; while group C received TET. All 60 participants were evaluated under the visual analog scale (VAS), the University of Washington Quality of Life questionnaire (UW-QOL) and the Vernier caliper scale (VCS) at the beginning of the therapies and after 4 weeks.
Results
ANOVA test revealed significant improvements across all three groups with outcomes of p<0.05. The results of the UW-QOL questionnaire showed a significant difference between groups A, B and C in favor of group A (p<0.05). The VAS results showed a more improvement in group A as compared to group B (p<0.05), while there was no statistical difference between groups B and C (p>0.05). The VCS results showed more improvement for the individuals in group B as compared to those in group C (p<0.05), while there was minimal difference between groups A and B (p>0.05).
Conclusion
The LIUS and TET are more effective than LLLT and/or TET in reducing TMJ pain and trismus following HNC.

Citations

Citations to this article as recorded by

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11,242 View
303 Download
18 Web of Science
23 Crossref

Case Reports

Severe Spastic Trismus without Generalized Spasticity after Unilateral Brain Stem Stroke: Jong-Hyun Seo, Don-Kyu Kim, Si Hyun Kang, Kyung-Mook Seo, Ju Won Seok; Ann Rehabil Med 2012;36(1):154-158. Published online February 29, 2012; DOI: https://doi.org/10.5535/arm.2012.36.1.154

Abstract
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A 62-year-old female patient diagnosed with left brain stem stroke 2 months ago was admitted to our clinic for rehabilitation. She had no generalized spasticity on both extremities, but could open her mouth only approximately 2 mm between her upper and lower teeth due to severe trismus. On needle electromyography, the left masseter muscle showed paradoxically increased muscle activity during mouth opening. We injected 50 units of type A botulinum toxin (Botox®) into the left masseter muscle, and 20 units into the left temporalis muscle with guidance of ultrasonography. The interincisal distance increased to 8 mm on the 3^rd day after injection, and 9 mm on the 4^th day. One month later, the interincisal distance increased to 14 mm. The increased interincisal distance was maintained for 13 months after injection, and the quality of hygienic care and compliance of oral stimulation therapy also improved.

Citations

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7,761 View
48 Download
7 Crossref

Effect of Botulinum Toxin A on Trismus after Traumatic Brain Injury: A case report.: Kang, Youn Joo , Oh, Jun Ho , Kim, Ji Sung , Shin, Sung Hun , Park, Kyung Tae; J Korean Acad Rehabil Med 2008;32(4):456-459.

Abstract
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We report a case of severe trismus following traumatic brain injury (TBI), which was treated successfully with botulinum toxin A. Its effect evidenced long-term resolution, for over one year. A 36 year-old man with a multifocal intracranial hemorrhage was admitted for quadriplegia with dysphagia and trismus. During ten months, a nasogastric tube was placed for feeding after TBI, and at that time his upper- to-lower interincisal distance was only 1.2 cm upon voluntary mouth opening. Botulinum toxin A 450 U (Dysport^Ⱂ) was injected into both masseter, medial pterygoid and left temporalis muscles under electromyographic guidance. The interincisal distance began to improve one week after injection. He successfully underwent percutaneous endoscopic gastrostomy, dysphagia rehabilitation therapy, and dental prosthesis. More than one month after injection, oral feeding proved possible. After 1 year his interincisal distance was maintained at 2.9 cm. (J Korean Acad Rehab Med 2008; 32: 456-459)