Criteria for trismus in head and neck oncology

Dijkstra, P.U.; Huisman, P.M.; Roodenburg, J.L.N.

doi:10.1016/j.ijom.2005.08.001

« Previous Next »International Journal of Oral & Maxillofacial Surgery
Volume 35, Issue 4 , Pages 337-342, April 2006

Criteria for trismus in head and neck oncology

P.U. Dijkstra
- Department of Oral and Maxillofacial Surgery, Division Oncology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
- Center for Rehabilitation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Center for Health Care Research, University of Groningen, Groningen, The Netherlands
- Address: P. U. Dijkstra, Department of Oral and Maxillofacial Surgery, University Medical Centre Groningen, University of Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands. Tel: +31 50 3610297; Fax: +31 50 3611708.
P.M. Huisman
- Private Practice, Amsterdam, The Netherlands
J.L.N. Roodenburg
- Department of Oral and Maxillofacial Surgery, Division Oncology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands

Accepted 3 August 2005.

Abstract

The aim of this study was to determine a functional cut-off point for trismus in head and neck oncology. In total, 89 patients (13 dentate, 30 partially dentate and 46 edentulous) treated for cancer of the oral cavity or oropharynx were asked whether they experienced a limited mouth opening. The mandibular function impairment questionnaire (MFIQ) was filled out and mouth opening was measured. The proportion correctly predicted (proportion true positives+proportion true negatives) was calculated. For cut-off points from 25 to 45mm, differences in MFIQ scores of the restricted and non-restricted groups were analyzed. A receiver operating curve was constructed. The proportion correctly predicted was highest for cut-off point ≤35mm (0.81), with a sensitivity of 0.71 and a specificity of 0.98. Differences in perceived mandibular function impairments were significant for all cut-off points of 35mm or less. For the total group, the area under curve was 0.87. For the subgroups of dentate, partially dentate and edentulous patients, no consistent cut-off points could be found on the basis of the proportion correctly predicted and the significance of the difference in MFIQ scores. A mouth opening of ≤35mm is a functional cut-off point for trismus in head and neck oncology patients.