Prevalence of Trismus and Its Impact on Oral Health-Related Quality of Life in Patients Treated for Oral Squamous Cell Carcinoma.

Shailesh Gondivkar,Rima Gondivkar,Shankargouda Patil,Amol Hedaoo,Balkrishna Sharma,Amol Gadbail,Sachin Sarode,Gargi Sarode,Aparna Sharma,Subhrajit Dasgupta,Monal Yuwanati,Rahul Gaikwad

doi:10.31557/apjcp.2021.22.8.2437

Abstract

Oral squamous cell carcinoma, one of the most common malignancies, has a poor prognosis due to impairment in oral functions secondary to treatment. Trismus one of the major causes of impairment of oral function. The present study investigated the prevalence of trismus and its impact on oral health-related quality of life (OHRQoL) in patients treated for oral squamous cell carcinoma (OSCC). The maximum inter-incisal mouth opening of hundred OSCC patients was recorded at post-treatment and 3 months post-treatment. OHRQoL questionnaire (OHIP-14) was intervened to assess the OHRQoL of patients post-treatment and 3 months follow-up, with emphasis on correlation with grades of trismus. The prevalence of trismus was 16% pre-treatment, 72% post-treatment, and 62% at 3 months after treatment. The overall OHIP-14 scores indicated that patients with trismus reported greater impairment of OHRQoL than those without trismus at the end of treatment and 3 months follow-up. At the end of treatment, patients with severe trismus demonstrated a higher mean OHIP-14 score (23.47 ±3.34) than those with moderate (17.72 ±2.83) and mild trismus (12.66 ±3.84) with statistically significant differences (p<0.001). Equivalent results were obtained at 3 months follow-up period. Patients with trismus suffer greater impairment of OHRQoL. The findings demand the need of identifying risk factors for developing trismus and early institution of newer/modified treatment approaches for better OHRQoL in OSCC survivors.

Highlights

Oral squamous cell carcinoma (OSCC) is the sixth most common malignancy in the world and is highly prevalent in South-Central Asia (Feller and Lemmer, 2012; Hernández-Guerrero et al, 2013)
The present study investigated the prevalence of trismus and its impact on oral health-related quality of life (OHRQoL) in patients treated for oral squamous cell carcinoma (OSCC)
The 48 % OSCC patient were in stage IV. 47 patients were treated with surgery alone whereas 22 patient with additional RT

Summary

Introduction

Oral squamous cell carcinoma (OSCC) is the sixth most common malignancy in the world and is highly prevalent in South-Central Asia (Feller and Lemmer, 2012; Hernández-Guerrero et al, 2013). In India, OSCC is the most common malignant neoplasm in males and third most common in females. Over 1,000,000 new cases of OSCC are registered every year in India (Warnakulasuriya, 2009). The curative management of OSCC affects cosmetic appearance and debilitate the integrity and vital functions of oral cavity such as speech, taste, chewing and swallowing. These oral dysfunctions adversely affect health-related quality of life (HRQoL) and should be addressed with utmost priority (Epstein et al, 2001; Kreeft et al, 2009). Owing to complex tri-dimensional anatomy of the mouth and proximity to vital structures, OSCC patients are considered different than those with other head and neck (H&N) cancers and use of sitespecific analysis of outcomes has been recommended in the literature (Chandu et al, 2006; Barrios et al, 2015)

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