物理治疗对颌骨癌放射治疗后牙关患者疼痛、下颌活动和口腔健康相关生活质量的影响:1例报告

S. Wani, Shreshthi Pramod Burnwal, Sanket S. Mungikar, Kapil Garg, Goutami Katage
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摘要

牙关是一种限制颞下颌关节活动范围(ROM)的疼痛状态,导致进食、咀嚼、说话等困难,影响口腔健康相关生活质量(OHRQOL)。它通常在恶性肿瘤前期或口腔癌治疗后出现并发症。其患病率在28%至79%之间,在无牙患者中发病率是无牙患者的8倍。患者57岁男性,1年前自诉舌头和下颚持续疼痛,咀嚼、进食和说话困难,右下颚逐渐出现小溃疡。经全面调查后,患者被诊断为颌骨癌,并接受了2个月的放疗。患者以疼痛、开口困难等主诉到理疗科就诊,放疗3个月后诊断为牙关。给予全面的物理治疗方案,包括激光,运动,肌筋膜释放,积极运动,为期4周。在基线和4周时评估疼痛、下颌活动和OHRQOL的结果。四周的综合物理治疗方案可有效减轻放射治疗后牙关患者的疼痛,改善下颌活动能力和OHRQOL。
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Physiotherapy for pain, jaw mobility, and oral health-related quality of life in patient with trismus following radiation therapy for jaw cancer: A case report
Trismus is a painful condition that restricts the temporomandibular joint range of motion (ROM) causing difficulty in eating, chewing, speaking, etc., affecting the oral health-related quality of life (OHRQOL). It often presents as a complication during pre-malignancy stage or after oral cancer treatment. Its prevalence is between 28% and 79%, and it is 8 times more common in edentulous patients. The 57-year-old male complained of continuous tongue and jaw pain with difficulty in chewing, eating, and speaking 1 year before and gradually developed small ulcers over the right jaw. After complete investigation, the patient was diagnosed with jaw cancer and underwent radiotherapy for 2 months. This patient came with complaints of pain, difficulty in mouth opening to physiotherapy department, 3 months following radiotherapy, diagnosed as a case of trismus. A comprehensive physiotherapy protocol including LASER, mobilization, Myofascial release, active exercises for the period of 4 weeks was given. Outcomes for pain, jaw mobility, and OHRQOL were evaluated at baseline and 4 weeks. Four weeks of comprehensive physiotherapy protocol was found effective in reducing pain and improving jaw mobility and OHRQOL in patients with trismus following radiation therapy.
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