Download Cwm Taf- Kerry Davies - Final Version

Cwm Taf UHB – for a study to look at early intervention to treat
problems with jaw opening in some head and neck cancer patients
Tumours in the mouth, back of the throat, base of tongue, salivary glands
and the upper and lower jaw may require Chemo-Radiotherapy (CRT) or
Radiotherapy (RT) to be delivered to areas including the jaw joints and
muscles. This can sometimes cause damage and scarring to these tissues
which can lead to Trismus, which is a reduction in mouth opening to less
than 35 mm.
Not being able to open your mouth enough can lead to a number of
issues, including poor oral hygiene, dental caries, difficulties with
intubation, problems with speech, as well as emotional distress and
reduced quality of life.
If people develop problems with opening their mouth after they have
finished their cancer treatment, the usual therapy offered is a program of
exercises using a jaw stretching device called a ‘TheraBite’. Speech and
Language Therapists working within the Head and Neck Cancer MDT
decided to investigate whether pre-emptive intervention for Trismus could
be of benefit to those patients at risk of developing symptoms.
11 patients were seen before their cancer treatment commenced and
were provided with a TheraBite device and exercise protocol to follow
every day for 6 months. Mouth opening measurements were taken during
this initial session and each subsequent month for 6 months. Selected
Quality of life questions were asked before, during and after their
treatment, and an exit interview carried out to assess the patients’
feelings about the changed treatment regime.
Although the study found that pre-emptive intervention for Trismus was
not suitable for all patients, it demonstrated that early intervention does
have a positive effect on mouth opening. Pre-emptive intervention will
now be implemented more widely as a result of the project, with the use
of clinical identifiers to select appropriate patients.