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| 2. |
- Karlsson, Ove, et al.
(författare)
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Jaw exercise therapy for the treatment of trismus in head and neck Cancer: a prospective three-year follow-up study
- 2021
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Ingår i: Supportive Care in Cancer. - : Springer Science and Business Media LLC. - 0941-4355 .- 1433-7339. ; 29, s. 3793-3800
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: This study aims to examine effects of jaw exercise on trismus 3years following completion of a post-radiotherapy jaw exercise intervention. Methods: Prospective study including 50 patients with head-and-neck cancer receiving radiotherapy and/or chemotherapy, plus a matched control group. The intervention group underwent 10weeks of jaw exercise training. Patients were followed pre-and postintervention and 3years postintervention completion. Outcome measures were maximal interincisal opening (MIO), trismus-related symptoms, and health-related quality-of-life as measured by Gothenburg Trismus Questionnaire, EORTC QLQ-C30, and EORTC QLQ-H&N35. Results: The intervention group had a statistically significantly higher mean MIO compared with the control group (40.1mm and 33.9mm, respectively, p < 0.001), reported less trismus-related problems and had an improved health-related quality-of-life when compared with the control group at the 3-year follow-up. These differences were all statistically significant. Conclusion: Jaw exercise therapy resulted in increased MIO, less trismus-related symptoms, and improved health-related quality-of-life. Jaw exercise therapy should be initiated early, in a structured manner and continued long-term. © 2020, The Author(s).
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| 3. |
- Åberg, Sebastian, 1991, et al.
(författare)
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Evaluation of Subjective Appetite Assessment under Free-Living vs. Controlled Conditions: A Randomized Crossover Trial Comparing Whole-Grain Rye and Refined Wheat Diets (VASA-Home)
- 2023
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Ingår i: Nutrients. - 2072-6643. ; 15:11
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Tidskriftsartikel (refereegranskat)abstract
- Background: Accurate assessment of self-reported appetite under free-living conditions is warranted to conduct large-scale intervention studies measuring appetite at a feasible cost. However, the performance of visual analogue scales (VASs) for this purpose has not been widely examined. Method: This randomized crossover trial was conducted to evaluate VASs in free-living vs. clinic-based settings and to assess appetite response following hypocaloric whole-grain rye and refined wheat diets. Twenty-nine healthy adults with overweight or obesity continuously answered VAS questions about their perceived appetite from morning to evening. Results: No differences in whole-day VAS scores (primary outcome) between clinic-based and free-living settings were observed, whereas measures of total area under the curve (tAUC) showed increased fullness in clinic-based interventions of 7% (p < 0.008) for whole-day responses and 13% (p < 0.03) following a snack. Appetite responses for a whole day did not differ between diets whereas rye-based dinners induced 12% (p < 0.016) higher fullness and reduced hunger by 17% (p < 0.02) irrespective of setting. A reduction in hunger of 15% (p < 0.05) was also observed following rye-based vs. wheat-based lunches. Conclusion: The results suggest that the VAS is valid for evaluation of appetite responses between diets under free-living conditions. No difference in self-reported appetite over the whole day was found after whole-grain rye vs. refined wheat-based diets, but there were some suggested differences at certain postprandial periods, in individuals with overweight or obesity.
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| 4. |
- Aghajanzadeh, Susan, et al.
(författare)
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A 5-year prospective study of health-related quality of life in irradiated head and neck cancer patients: three trends of HRQL over time
- 2023
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Ingår i: European Archives of Oto-Rhino-Laryngology. - : Springer Science and Business Media LLC. - 0937-4477 .- 1434-4726. ; 280:5, s. 2617-22
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Tidskriftsartikel (refereegranskat)abstract
- Purpose Head and neck cancer (HNC) is one of the fastest increasing cancer-types, where both disease and oncologic treatment have severe impact on health-related quality of life (HRQL). This study aimed to report HRQL prospectively up to 5-years following radiotherapy-treatment in HNC and to, if possible, identify trends in HRQL over time. Methods This prospective study followed 211 patients receiving curatively intended radiotherapy pre-diagnosis, 3-, 6-, 12- and 60-months post-radiotherapy completion. HRQL was measured using EORTC QLQ-C30 and EORTC QLQ-HN35. Results A deterioration three months post-radiotherapy was reported in 14/15 domains of EORTC QLQ-C30. Eight out of 12 domains had recovered to baseline-values at 12 months post-radiotherapy and remained unchanged up to study endpoint. Corresponding figures for EORTC QLQ-HN35 were deteriorations in 15/16 domains at three months post-radiotherapy, with recovery of 5 domain at 12-months, whereas the other 11 domains remained significantly worse at 5-years post-RT compared to baseline. Conclusion Following the deterioration in HRQL seen immediately following radiotherapy, the continued course of HRQL can be divided into three trends: short-term deterioration, long-term deterioration and long-term improvements. The combination of disease- and diagnosis-specific questionnaires is crucial when assessing HRQL in the HNC population.
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| 5. |
- Aghajanzadeh, Susan, et al.
(författare)
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A prospective 5-year study of trismus prevalence and fluctuation in irradiated head and neck cancer patients
- 2022
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Ingår i: Acta Oto-Laryngologica. - : Informa UK Limited. - 0001-6489 .- 1651-2251. ; 142:7-8, s. 620-626
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Tidskriftsartikel (refereegranskat)abstract
- Background Trismus is a complication post-radiotherapy for head and neck cancer (HNC), which causes pain, eating limitations and reduced quality-of-life. However, little is known about the condition long-term or how trismus fluctuates within an irradiated population. Aim/Objective To prospectively map trismus prevalence in irradiated HNC patients up to 5-years following treatment completion including describing intra-group fluctuation of maximum interincisal opening (MIO). Materials and Methods 211 patients receiving curatively intended radiotherapy for HNC were included in this prospective study. Patients were followed pre-radiotherapy (baseline), 3-, 6-, 12-, 24-, 36- and 60-months post-radiotherapy completion using MIO. Results Mean MIO at baseline, 12-months and 5-years following radiotherapy were 51.5 mm, 41.7 mm and 41.3 mm respectively. A total of 28% (n = 36) fulfilled the trismus criterion at 5-years post-radiotherapy. Eighty percent of patients (n = 24) with trismus at 5 years post-radiotherapy also suffered from trismus at 12 months post-radiotherapy, whilst 88-92% of all patients reported reduced MIO at any given timepoint compared to baseline. 15% of patients never exceeded an MIO of >35 mm at any time-point. Conclusion Trismus is a prevalent long-term complication of HNC and its treatment, which does not appear to heal spontaneously. The majority of fluctuations in MIO occur during the first 12 months post-radiotherapy completion.
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| 6. |
- Aghajanzadeh, Susan, et al.
(författare)
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Facial pain, health-related quality of life and trismus-related symptoms up to 5years post-radiotherapy for head and neck cancer
- 2023
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Ingår i: Supportive Care in Cancer. - 0941-4355 .- 1433-7339. ; 31:12
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Pain is a frequent symptom of head and neck cancer (HNC) but longitudinal studies investigating facial pain are scarce. We aimed to investigate prevalence of facial pain, its effect on health-related quality of life (HRQL) and trismus-related symptoms in a HNC cohort. Methods: Patients (n = 194) were prospectively followed post completion of radiotherapy (RT). Outcome measures included facial pain, HRQL, trismus-specific symptoms, and maximal interincisal opening (MIO). Results: Facial pain was reported by 50% at baseline. Corresponding figures for 3-, 12-, and 60months post-RT were 70%, 54% and 41%. Moderate to severe pain was reported in 29–44% of patients reporting pain during the study period. Patients reporting pain scored significantly worse on more HRQL variables and trismus symptoms, as well as had significantly smaller MIO at all follow-up time points. Conclusions: Facial pain was common in HNC patients pre- and post-RT and remained prevalent up to 5years after completion of RT. Reductions in MIO were associated with more facial pain. Pain was also associated with worse HRQL.
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| 7. |
- Aghajanzadeh, Susan, et al.
(författare)
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Postradiation trismus in head and neck cancer survivors: a qualitative study of effects on life, rehabilitation, used coping strategies and support from the healthcare system
- 2024
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Ingår i: EUROPEAN ARCHIVES OF OTO-RHINO-LARYNGOLOGY. - 0937-4477 .- 1434-4726.
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Tidskriftsartikel (refereegranskat)abstract
- Purpose This study aimed to explore the experiences of head and neck cancer (HNC) survivors with postradiation trismus, specifically how oncological treatment affected their lives, rehabilitation, use of coping strategies, and healthcare experiences. Methods: A qualitative descriptive approach was used and semi-structured interviews of 10 HNC survivors with postradiation trismus were conducted 6-30 months after completing oncological treatment. The interviews were transcribed verbatim and analyzed by qualitative content analysis.Results The analysis of interviews yielded four main categories: Bodily symptoms, Effects on life, Support from the healthcare system, and Strategies to handle life and symptoms. Participants reported ongoing problems with xerostomia, dysgeusia, eating, and limited physical fitness. Pain related to trismus was not a major issue in this cohort. Participants expressed limitations in their social lives due to their eating difficulties, yet a sense of thankfulness for life and overall satisfaction with the healthcare they received. Psychological and practical coping strategies developed by the participants were also revealed.Conclusion The results highlight areas of unmet need among HNC survivors that healthcare providers can target by establishing multi-professional teams dedicated to individualizing post-cancer rehabilitation care.
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| 8. |
- Aghajanzadeh, Susan, et al.
(författare)
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The effect of jaw exercises on anxiety and depression in patients with head and neck cancer receiving radiotherapy: Prospective 2-year follow-up study
- 2020
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Ingår i: Head and Neck-Journal for the Sciences and Specialties of the Head and Neck. - : Wiley. - 1043-3074. ; 42:2, s. 330-335
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Tidskriftsartikel (refereegranskat)abstract
- Background This nonrandomized matched study investigates jaw exercise effect on anxiety/depressive symptoms in head and neck cancer patients with trismus during 2 years postradiotherapy. Methods Fifty patients with trismus postradiotherapy were included in a 10-week jaw-training intervention. A matched control group was included (N = 50). Maximum interincisal opening (MIO) <= 35 mm was used as the trismus criterion. Patients were assessed using MIO and Hospital Anxiety Depression Scale preintervention, postintervention, and at 2-year follow-up. Results A significant difference was found in depressive symptoms between the intervention group and control group (4% vs 33%) at 2-year follow-up, with more control group patients reporting possible depression. In the intervention group, significantly fewer patients had possible/probable depressive symptoms at follow-up (4%) compared to preintervention (34%). No change was seen within the control group. Conclusion Structured jaw exercise in patients with postradiation trismus had positive effects on MIO and depressive symptoms but does not seem to have any significant effects on anxiety symptoms.
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| 9. |
- Aghajanzadeh, Susan, et al.
(författare)
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Trismus, health-related quality of life, and trismus-related symptoms up to 5 years post-radiotherapy for head and neck cancer treated between 2007 and 2012
- 2023
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Ingår i: Supportive Care in Cancer. - : Springer Science and Business Media LLC. - 0941-4355 .- 1433-7339. ; 31:3
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Radiotherapy-induced trismus is present in up to 40% of patients treated radiotherapeutically for head and neck cancer (HNC) and impacts health-related quality of life (HRQL) negatively. This prospective study aimed to investigate the development of trismus and its influence on HRQL and trismus-related symptoms in HNC patients for up to 5 years post-radiotherapy completion as no such follow-up studies exist. Methods: Patients (n = 211) were followed prospectively from pre-radiotherapy to 12 and 60 months post-radiotherapy. At each follow-up, maximum interincisal opening (MIO) was measured, and patients filled in the European Organization for Treatment of Cancer Quality-of-Life Questionnaire Core-30 (EORTC QLQ-C30), Head and Neck-35 (EORTC QLQ-HN35), and Gothenburg Trismus Questionnaire (GTQ). Trismus was defined as an MIO ≤ 35 mm. Results: At 1 year post-radiotherapy, a total of 27% met the trismus criterion, and at 5 years post-radiotherapy, the corresponding figure was 28%. Patients in the trismus group scored significantly worse compared to the patients without trismus on 8/15 domains at 1 year post-radiotherapy on EORTC QLQ-C30, further worsening in 11/15 domains at 5 years post-radiotherapy. Similar results were found for EORTC QLQ-HN35. Patients with trismus reported more trismus-related symptoms according to the GTQ at both timepoints compared to those without trismus. Conclusion: This study highlights that HNC patients suffering from radiotherapy-induced trismus report poorer HRQL and more trismus-specific symptoms compared to patients without trismus. These differences persist and increase up to at least 5 years following treatment completion. Hence, our results highlight that radiotherapy-induced trismus affects long-term HRQL, jaw symptoms, and pain, further stressing the need for early and structured intervention.
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| 10. |
- Folkestad, Lena, 1960, et al.
(författare)
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Orbital floor fractures-a comparison between CT images and findings at surgery
- 2023
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Ingår i: European Archives of Oto-Rhino-Laryngology. - : Springer Science and Business Media LLC. - 0937-4477 .- 1434-4726. ; 280:6, s. 2795-2803
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Tidskriftsartikel (refereegranskat)abstract
- Purpose The present study aims to investigate how well CT images correlate to surgical findings in orbital floor fractures and to the presence of diplopia. Methods In this cross-sectional study, 27 consecutive patients already selected for surgery due to an orbital floor fracture underwent a routine CT scan (axial, coronal, sagittal). An ophthalmologist established any presence of diplopia. Extent of fracture/injury seen on CT was compared to that discovered during surgery. Results In the surgeons & PRIME; opinions CT-images were in concordance with surgical findings in 71% of the cases. Agreement for pure blow out fractures was high (92%). Tetrapod fractures as a cause of an orbital floor fracture was only identified as such by surgeons in three of 11 cases, all subjected to orbital exploration, not only a closed reduction. Diplopia showed a significant correlation to rounding of the inferior rectus muscle at coronal CT. "Rounding " significantly correlated with the presence of a floor defect, to herniation of soft tissues and to the volume of displaced tissue. Conclusions The results imply that the joint professional interaction between neuroradiology and surgery is important and would benefit from the use of an easy and well-defined classification system of orbital floor fractures. In Sweden a national record to collect data on all zygomaticomaxillary complex fractures assessed is to be started aiming at making general statements possible by time.
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