A Comparison of the Dynasplint Trismus System to Tongue Depressor Therapy in Improving Treatment-Related Trismus

Abstract

Objectives:

(1) Evaluate and compare the effectiveness of tongue depressors and the Dynasplint Trismus System to manage trismus in head and neck cancer patients. (2) Analyze factors that may indicate improved outcomes for patients in trismus management.

Methods:

Single-institution randomized controlled cross-over study (2007-2013). Fifty-three patients with trismus as a complication of cancer treatment were enrolled in the study at an academic tertiary care center. Twenty-seven patients were randomized to a treatment arm using Dynasplint, while 26 were enrolled in a treatment arm using tongue depressors to perform stretching exercises. The primary outcome was interval measurement of incisor-to-incisor opening during and at the completion of tongue depressor therapy compared to Dynasplint usage. Pretreatment and treatment characteristics, including type of cancer treatments used, were analyzed for association with rate of improvement.

Results:

Dynasplint and tongue depressors both significantly increased the maximal incisal opening of patients at 3 months compared with baseline (P < .01 in both treatment arms). A statistically significant difference in outcomes between the treatment arms was not found at any time point. Patients who received only surgery and no radiation showed significantly more improvement in maximal incisal opening from baseline to 3 months (P = .0036) and 6 months (P = .012).

Conclusions:

Surgical therapy alone responds better to trismus therapy compared to dual modality therapy. Both Dynasplint Trismus System and tongue depressors were able to improve the trismus status for patients with equal effectiveness. Ease of use and cost favor the management with tongue depressors.