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Title: Radiation-induced temporo-mandibular joint disorder in post-radiotherapy nasopharyngeal carcinoma patients : assessment and treatment
Authors: Wu, VWC 
Lam, YN 
Issue Date: Jun-2016
Source: Journal of medical radiation sciences, June 2016, v. 63, no. 2, p. 124-132
Abstract: Nasopharyngeal carcinoma (NPC) is endemic in southern China, and its incidence in Hong Kong is relatively high. Radiotherapy is the mainstay treatment for NPC due to its relatively high radiosensitivity and deep-seated anatomical position, which is not readily accessible by surgery. Although the technique of radiotherapy in NPC has been advancing and offers promising treatment outcome, complications around the irradiation areas are inevitable and the quality of life of the post-radiotherapy patients is often compromised. Trismus, which is defined as the restricted mouth opening or jaw movement due to the disorder of temporo-mandibular joint (TMJ), is one of the possible late complications for radiotherapy of NPC and is found in 5-17% of the post-radiotherapy (post-RT) patients. Trismus at early stage may only affect the speech, but in severe cases nutritional intake and oral hygiene condition may deteriorate seriously. This article reviewed the possible causes of radiation-induced TMJ damage, the various assessments including imaging modalities and possible treatments. The conclusion is that the availability of simple, yet effective examinations for trismus is essential for delaying the progression and restoring TMJ functions. Although there is no absolutely effective treatment for trismus, many supportive, restorative and palliative management are possible under different clinical situations.
Keywords: Imaging modalities
Nasopharyngeal carcinoma
Radiation-induced trismus
Radiotherapy
Temporo-mandibular joint
Publisher: John Wiley & Sons
Journal: Journal of medical radiation sciences 
ISSN: 2051-3895
EISSN: 2051-3909
DOI: 10.1002/jmrs.145
Rights: © 2015 The Authors. Journal of Medical Radiation Sciences published by Wiley Publishing Asia Pty Ltd on behalf of Australian Institute of Radiography and New Zealand Institute of Medical Radiation Technology. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
The following publication Wu, V. W., & Lam, Y. N. (2016). Radiation‐induced temporo‐mandibular joint disorder in post‐radiotherapy nasopharyngeal carcinoma patients: assessment and treatment. Journal of Medical Radiation Sciences, 63(2), 124-132 is available at https://doi.org/10.1002/jmrs.145
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