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September 05-06, 2019 | London, UK
7th International Conference on
2nd International Conference on
Otolaryngology: ENT Surgery
Dental Health and Oral Hygiene
Joint Event
&
Otolaryngology Online Journal | ISSN: 2250-0359 | Volume 9
Surgical management of trismus following multidisciplinary head and neck cancer
treatment
Dougal Buchanan
Royal Melbourne Hospital, Australia
Background: Trismus is a common postoperative sequela
of head and neck cancer treatment, which may include
ablative surgery, reconstructive surgery, and adjuvant
radiotherapy. This paper set out to describe a stepwise
approach to surgical management of trismus, with case
demonstrations of outcomes we have achieved.
Methods: Between May of 2014 and June of 2018, 8 patients
were operated on for release of trismus and reconstruction
after previous intraoral surgery. The patients had been
reconstructed with skin grafts (n=2), radial forearm flaps
(n=3), anterolateral thigh flaps (n=4). 5 patients had received
postoperative radiotherapy. The patients presented with a
mean interincisal distance of 17.2mm (range, 6 to 28mm).
Results: Our approach to trismus release included myotomy
and coronoidotomy. the intraoral soft-tissue defects were all
reconstructed with free flaps. Average interincisal distance
was 42.5mm immediately after the release (range, 33 to 52
mm) and 34.3mm (range, 24 to 49 mm) at a mean follow-
up time of 14 months. The mean amount of improvement
amongst all operated patients was 17.1mm.
Conclusion: A stepwise intraoperative approach to trismus
release and the use of free flaps to reconstruct any defect is
an effective means of achieving long lasting improvement of
trismus for patients previously treated for following previous
head and neck cancer treatment.
e:
Otolaryngology online
Volume: 9