The Importance of Self-Rehabilitation in Irradiated Head and Neck Cancer Patients

OBJECTIVE Restricted mouth opening (trismus) is a common late effect of radiotherapy (RT) in patients (pts) with head and neck cancer. This study aims to reveal whether self -rehabilitation therapy, without any apparatus utilized after RT, has any therapeutic impact on trismus and mouth opening distance (MOD) in head and neck cancer pts. METHODS Fifty-three consecutive pts with squamous cell carcinoma of the head and neck treated with RT +/- chemotherapy (ChT) were included in the study. An MOD of less than 35mm was accepted as trismus. Self -rehabilitation exercises were started 3 months after RT and continued for 3 months. The risk factors for trismus and MOD in relation to exercises were determined using univariate and multivariate statistics. RESULTS The median age was 59 years (range: 31-84). Trismus was present in 41.5% of the group as a whole (22 of 53 pts). The MOD for the entire group prior to physiotherapy was 37.33 +/- 7.83mm, and it was 38.75 +/- 7.66mm after physiotherapy (p=0.035). In multivariate analysis, concomitant ChT (OR=5.648, 95% CI: 1.043-30.596) and time passed after RT of more than 36 months (OR=8.238, 95% CI: 1.410- 48.136) were found to significantly increase the risk of trismus. However, when physiotherapy is used, these risk factors lose their significance. CONCLUSION Self -rehabilitation without the use of any apparatus was discovered to be an effective treatment for trismus after RT for the first time. We also discovered that self -rehabilitation improves the MOD values of the entire patient population.