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Results for “TRISMUS”

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At least 19 recordsLinked to original sources

PubMed1993

Trismus in patients with malignant tumours in the head and neck.

In order to elucidate the causal mechanism of trismus in head and neck cancer, 21 patients manifesting trismus out of 212 patients with malignant tumours in the head and neck (treated in Tokyo University Branch Hospital from 1983 to 1991) were reviewed. Nine patients developed trismus either by infiltration of the muscles of mastication or by reflex spasm. Trismus was considered to have developed as a result of irradiation in five cases and of surgical intervention in seven cases. In some cases of oropharyngeal cancer, CT revealed no evidence of tumour invasion into the infratemporal fossa when trismus occurred, suggesting that trismus was caused either by the reflex spasm of muscles or by microinvasion too small to be seen in CT films. Maxillary sinus tumours were often without trismus even when they extended posteriorly to the infratemporal fossa.

Adult↗

PubMed2001

A pilot study of pentoxifylline in the treatment of radiation-induced trismus.

Radiation-induced trismus has a significant impact on the quality of life of patients receiving radiotherapy for head and neck cancers. Pentoxifylline has immunomodulatory activities that downregulate certain cytokines that have been implicated as mediators of fibrogenic reactions after radiation. A pilot study was therefore conducted to evaluate the efficacy of pentoxifylline in the treatment of radiation-induced trismus. Twenty patients with severe trismus (dental gap < or = 25 mm) after receiving radiotherapy for nasopharyngeal carcinoma were enrolled onto the study. Four patients were excluded from analysis because of poor drug compliance. The remaining 16 evaluable patients completed an 8-week course of pentoxifylline at a dose of 400 mg two to three times daily. Changes in dental gap were recorded by measuring the distance between left upper and lower incisor before and after treatment. At the end of treatment, 10 patients had a measured increase in dental gap ranging from 2 to 25 mm. Six patients had an increment of 5 mm or more. The mean dental gap before treatment was 12.5 mm compared with 16.5 mm at the end of treatment (p = 0.023). The mean difference in dental gap was 4 mm, with a 95% confidence interval of 0.6 to 7.4 mm. The drug pentoxifylline appears to exert a modest therapeutic effect in patients with radiation-induced trismus, although our findings need to be confirmed by a randomized placebo-controlled study. While awaiting more evidence from clinical studies, a therapeutic trial of pentoxifylline is worth considering in patients experiencing radiation-induced trismus.

Adult↗

PubMed1998

[Is a maxillary prosthesis difficult for patients with trismus?].

Of patients with a postoperative maxillary defect, around 30% are though to have trismus to some extent. In these patients, some difficulty in fabricating a maxillary prosthesis is expected. In this study, 54 patients with trismus were compared with a control group to find some proof of difficulty in making a maxillary prosthetics. Fifty-four of trismus less than 20 mm of a mandibular stroke were experienced out of 185 patients with maxillary prosthetics between October 1984 and October 1992. The trismus was divided into 4 groups of less than 5 mm (1 case), 5 mm-10 mm (10 cases), 11 mm-15 mm (19 cases), and 16 mm-20 mm (24 cases). These case were analyzed by in taking an impression failure, average weight of the prosthesis, time needed to complete the prosthesis and some special form of prosthesis. No apparent differences among the 4 groups or with the control group were found. The cause of the difficulty in making a prosthesis for such patients with trismus are suggested not to be simply due to the range of mouth opening but also to the complexed space formed by the dental defect, alveolar bone defect, spreadability of the lip and the cheek, the mandibular stroke and the so-called scar bundle of the cheek next to the defect.

Adult↗

PubMed1992

Evaluation of trismus after treatment of mandibular fractures.

This retrospective study examines the effects of treatment modalities and other contributing factors on the duration of trismus following mandibular fractures. Under a strict protocol, 80 cases involving a total of 120 fractures and their treatment modalities were reviewed. An investigation of duration of trismus was carried out in several ways. Although a relationship was established between age, initial interincisal distance, and duration of trismus, no relationship was found with the number or location of fractures, or reduction method. However, after examining the fixation methods separately, it was found that those cases in which Champy plates were used experienced a shorter duration of trismus compared with those using closed reduction with maxillomandibular fixation.

Adolescent↗

PubMed2004

Coronoidectomy in maxillary swing for reducing the incidence and severity of trismus--a reminder.

PURPOSE: The maxillary swing approach is a proven method for access to the nasopharynx. However, often, trismus is incurred postoperatively, hampering adequate oral care and follow-up and affecting patients' quality of life. CASE REPORTS: Coronoidectomy was performed in four patients undergoing maxillary swing. Minimal trismus was seen in one patient undergoing repeat irradiation and chemotherapy. After a 1-month period no trismus was observed in the other three patients. CONCLUSION: Coronoidectomy, usually performed in maxillectomy for reducing trismus is a useful adjunct in the maxillary swing procedure.

Humans↗

PubMed1997

Trismus and pain after removal of impacted lower third molars.

PURPOSE: This study evaluated trismus and pain after removal of impacted lower third molars and investigated whether these responses were related to difficulty of surgery. PATIENTS AND METHODS: A consecutive series of 104 patients, all of whom underwent removal of an impacted lower third molar under local surgery, was studied. Difficulty of surgery was evaluated on a modified version of the Parant scale: I, extraction with forceps only; II, extraction by ostectomy; III, extraction by ostectomy and coronal section; IV, complex procedures. Trismus was evaluated in terms of maximum interincisal distance (MID) 1 and 5 days after surgery. Pain was evaluated on the basis of reported analgesic use 1 and 5 days after surgery. RESULTS: Among group I subjects, mean day 1 MID did not differ significantly (P > .05) from mean presurgery MID, whereas mean day 1 MID in groups II, III, and IV was significantly lower than before surgery. In groups II, III, and IV, mean day 5 MID remained lower than before surgery. The proportion of group I patients using analgesics was significantly lower on both days 1 and 5 than the proportion of patients using analgesics in groups II, III, and IV. In all groups, the proportion of patients using analgesics dropped significantly between days 1 and 5. CONCLUSION: Trismus is less severe after simple (forceps-only, grade I) extractions than after surgical extractions (grades II to IV). However, trismus severity after surgical extraction does not depend on difficulty of surgery. Pain, as revealed by reported analgesic use, is likewise less severe after simple extractions. Regardless of extraction type, pain declines between days 1 and 5 postsurgery.

Adolescent↗

PubMed1992

Modified use of a dynamic bite opener--treatment and prevention of trismus in a child with head and neck cancer: a case report.

Trismus may be a complication arising during or after treatment of patients with head and neck cancer. Treatment of trismus is difficult, making prevention very important. To prevent and treat trismus in a patient with a nasopharyngeal tumor, the Contract-Relax-Antagonist-Contract (CRAC) technique was applied, with the aid of a custom-made dynamic bite opener (DBO). The CRAC technique in combination with the DBO, as a therapy/prevention program for trismus, is not referred to in the literature. The combination of CRAC and DBO appeared to be a gentle and effective method well tolerated by the patient.

Adolescent↗

PubMed1999

Congenital trismus secondary to masseteric fibrous bands: endoscopically assisted exploration.

The authors present an 18-month-old female infant with congenital trismus. Computed tomography and magnetic resonance imaging were not helpful in determining the cause. A surgical endoscope was used to explore her temporomandibular joints and temporal fossae, thus avoiding the morbidity of a bicoronal incision. The cause was bilateral fibrous bands on the anterior border of the masseter muscles. Incision of these fibrous bands led to relief of the trismus. This finding is consistent with a previously described variant of the Hect-Beals-Wilson trismus-pseudocamptodactyly syndrome. This patient, however, had no evidence of the autosomal dominant inheritance pattern nor did she exhibit pseudocamptodactyly, both of which are generally ascribed to this syndrome. Unfortunately the trismus recurred 3 months postoperatively.

Abnormalities, Multiple↗

PubMed2002

Trismus in a 6 year old child: a manifestation of leukemia?

Trismus is a firm closing of the jaw due to tonic spasm of the muscles of mastication from disease or the motor branch of the trigeminal nerve. Trismus may be produced by a variety of reasons such as dental abscess, trauma, following mandibular block with local anesthesia, as a result of radiation to the facial muscles, and patients after chemotherapy. A case of a referral of a six-year-old boy to a dentist from an ENT due to severe limitation in jaw opening is presented. Intraoral examination and panoramic radiograph demonstrated no signs of infection and/or other pathology. After a diagnosis of trismus was made, due to his icteric appearance, the general fatigue and loss of appetite in the last few days, palpated and sensitive lymph nodes in the submandibular and cervical regions, the child was referred for a complete blood count and sedimentation rate. The laboratory and clinical findings resulted in the diagnosis of acute lymphoblastic leukemia (ALL). Dental and oral manifestations of ALL are discussed, and the trismus may be explained by an intensive infiltration of leukemic cells into the deep portion of the contracting muscles of the face. This case emphasizes the importance of physical examination and independent judgement made by dentists, even when patients are referred to them by other members of the medical communities.

Blood Cell Count↗

PubMed2000

Effects of reduced mouth opening capacity (trismus) on pulmonary function.

In this study, pulmonary function test data were obtained from 15 healthy volunteers and 15 patients with slightly impaired ventilation during both normal and maximally reduced opening of the mouth (trismus, intercuspal position). The aim of the study was to examine the effects of complete trismus on pulmonary function using objective and subjective parameters. In maximally reduced mouth opening, both groups showed an impairment of all subjective and objective pulmonary function test data. In healthy volunteers, the significant changes in test data (P<0.05) stimulated mild to moderate pulmonary impairment, whereas patients with an already impaired pulmonary function showed a marked deterioration of their initial respiratory condition. The results of the subjective and objective parameters examined indicate that an intercuspal position (trismus) further aggravates pulmonary functional impairment. Complete trismus can be considered a risk factor to pulmonary function in patients using mouth breathing as a primary or supportive mode of respiration.

Adult↗

PubMed1989

[Chronic trismus in the severe skeletal Class III cases].

In general, patients who have trismus as chief complaint often have acute symptoms, but limited number of these patients have chronic trismus. We studied 51 patients (mean age; 18y 4n) with severe skeletal class III (less than ANB less than or equal to O), who need surgical treatment. Three types were classified according to the movement of the mandibular head at the maximum mouth opening at their first visit. A-type; the mandibular head hardly move. B-type; it dose not move beyond articular eminence. C-type; it moves beyond articular eminence. These classifications were applied to the both sides of the mandibular head in the 51 patients to divide into 5 types (Type AA, Type AB, Type BB, Type BC, Type CC). Those patients were analyzed according to these five types. The results obtained were as follows; 1) Seventy-three percent of all the cases were female in this study. Sixty-five percent of both the sexes had chronic trismus without having subjective symptoms on the mandibular joints in their daily lives. Type AA, AB, BB, and BC accounted for 12%, 6%, 31%, and 16% respectively. 2) There were fewer contacts in the upper posterior antagonist teeth in AA and AB; particularly at 5. In all the cases of Type CC, contacts with the antagonist tooth 5 were seen. 3) As a conclusion, movement of the mandibular head in the patients with trismus are found to have a characteristic limitation at the maximum mouth opening and the stress points in the occlusal contacts at the centric occlusion to be the posterior area.

Adolescent↗

PubMed1983

[Diagnosis of trismus, excluding tetanus and local causes].

The most frequent causes of trismus are tetanus and local lesions. This report discusses other etiologies. Trismus is usually only a secondary sign of a rich clinical picture, but may be of diagnostic value in some cases. Emphasis is placed on the frequency of involvement of neuroleptic intoxication, the early onset of trismus in the malignant hyperthermia syndrome, and on the useful role of trismus in the localization of neurological lesions.

Humans↗

PubMed1998

[Effects of limited mouth opening capacity (trismus) on lung function].

In the present study pulmonary function test data were obtained from 15 healthy volunteers and 15 patients with slightly impaired ventilation during both normal and maximally reduced opening of the mouth (trismus, intercuspid position). The aim of the study was to examine the effects of complete trismus on pulmonary function using objective and subjective parameters. In maximally reduced mouth opening, both groups showed an impairment of all subjective and objective pulmonary function test data. In healthy volunteers, the significant changes in the test data (p < 0.05) simulated mild to moderate pulmonary impairment, whereas patients with an already impaired pulmonary function showed a marked deterioration of their initial respiratory condition. The results of the subjective and objective parameters examined indicate that an intercuspid position (trismus) further aggravates pulmonary functional impairments. Complete trismus can be considered a risk factor to pulmonary function in patients using mouth-breathing as primary or supportive mode of respiration.

Adult↗

PubMed1975

[Trismus, trigeminal motor dyssynergy with brain stem lesions (author's transl)].

Paradox activity of masticatory muscles was observed clinically and electromyographically in 4 patients with brain steem lesions who had trismus. There was no activity in the elevators of the jaw on the side affected during voluntary biting, as if the muscles were paralyzed. There was strong activity of the elevators on the side of the trismus on opening the mouth, inactivity on the unaffected side, or inverse activity appeared on both sides. In view of the trigeminal anesthesia on the side of paradox activation, and the absence of pyramidal signs, a stretch reflex mechanism and abolition of inhibition can not be the only basis for these phenomena; so, a disturbance of bilateral synergism, in the sense of an internuclear lesion, is postulated. In one case of motor and sensory paralysis after the extirpation of a meningioma of the cerebellopontine angle, intensive paradox activity was observed, without trismus.

Adult↗

PubMed1986

Oropharyngeal carcinoma presenting as an odontogenic infection with trismus.

Severe odontogenic infections involving muscles of mastication are often accompanied by trismus at the initial presentation. On rare occasions a nasopharyngeal tumor will have trismus as a presenting symptom. We report a case of odontogenic infection requiring emergency management in which trismus did not resolve. On further investigation, a nasopharyngeal carcinoma was diagnosed.

Carcinoma, Squamous Cell↗

PubMed1998

Evaluation of trismus, bite force, and pressure algometry after third molar surgery: a placebo-controlled study of ibuprofen.

PURPOSE: This study evaluated trismus, bite force, and pressure algometry as measures of analgesic efficacy after third molar removal. PATIENTS AND METHODS: Fifty-seven patients (36 females and 21 males) developed at least moderate pain after surgical removal of a mandibular third molar and were given either ibuprofen, 400 mg (n = 26), or placebo (n = 31) in a double-blind study. Pain intensity and pain relief were rated on a five-point verbal rating scale during the 4-hour study period. Recordings of trismus, bilateral pressure pain detection and tolerance thresholds, and bite force were performed before surgery, at medication, and hourly for 4 hours. Changes in the functional variables were calculated as percent change from baseline (before surgery). RESULTS: The pain intensity and pain relief ratings showed significant differences between the ibuprofen- and placebo-treated patients in the 4-hour study period. The changes in trismus, bite force, and pressure pain thresholds were in accordance with these pain ratings. Pressure pain detection threshold on the operated side was significantly lower in the placebo-treated patients compared with the ibuprofen-treated patients 2 and 3 hours after medication, whereas pressure tolerance threshold showed a significant difference after 2 hours. Bite force on the operated side was significantly less reduced 3 hours after treatment with ibuprofen when compared with placebo. CONCLUSIONS: The functional measures used support the results obtained by rating of pain intensity and pain relief, and could be of value as measures of the efficacy of an analgesic to reduce functional impairment caused by postoperative pain.

Adolescent↗

PubMed1979

Postoperative swelling and trismus after mandibular third molar removal with the lingual split bone technique.

Several factors have been suggested as possible causes for the development of the swelling and trismus which occur after the surgical removal of impacted third molar teeth. In this investigation, measurements of swelling and trismus were made before and after lower third molar removal by the lingual split technique, in a series of 53 patients. No single cause of these surgical sequelae was identified and the duration and pattern of both swelling and trismus were recorded.

Edema↗

PubMed1998

An association between imaging and acute posttraumatic ear bleeding with trismus.

OBJECTIVES: Computed tomography findings for each of 94 patients with unilateral ear bleeding and trismus correlated with either comminuted temporal bone fracture (26 cases) or bilateral temporomandibular joint fracture (68 cases). STUDY DESIGN: Ninety-four patients with post-traumatic unilateral ear bleeding and 10 asymptomatic adults underwent coronal computed tomography examinations of their temporomandibular joints. Of these, 26 patients with intact temporomandibular joints underwent axial computed tomography of the temporal bones. For 23 of the 94 symptomatic patients, computed tomography was the final imaging procedure; for the other 71 symptomatic patients, it was the first imaging procedure. Quantifications of the radiation dose and the per-patient cost of imaging were performed. Measurement of the maximal mandibular movements in vertical and horizontal directions was performed clinically in the 10 asymptomatic adult control subjects and in the 94 patients with trismus and ear bleeding. RESULTS: Ten control subjects had maximal opening values of 40 mm or more, and horizontal movement exceeded 24 mm. In 68 symptomatic patients, coronal computed tomography demonstrated bilateral fracture: there was bilateral high condylar fracture in 35 patients, and there was ipsilateral to the bleeding high condylar fracture with contralateral subcondylar fracture dislocation in 33 patients. Axial computed tomography scans in 26 symptomatic patients with intact temporomandibular joints demonstrated comminuted petrous bone fracture ipsilateral to the ear bleeding. CONCLUSIONS: Patients with post-traumatic ear bleeding associated with trismus should first be evaluated by computed tomography. Any other initial procedure doubles the radiation dose as well as the cost of the imaging.

Acute Disease↗