ABSTRACT
Trismus is the most common sequelae of various pathological processes leading to compromised nutritional state in addition to physical and psychological disabilities. Therapeutic interventions are available to relieve trismus, which range from oral usage of pharmacological agents to intralesional steroid therapy. Intraoral appliance therapy can be employed as an alternative or adjuvant treatment for radiotherapy-induced fibrosis and autoimmune disorders such as scleroderma, psychogenic trismus, and oral submucous fibrosis, decreasing the adverse effects associated with other pharmacological interventions. A novel intraoral appliance-"Nallan C-H"-has been developed and tried for trismus producing better results. A report on three such cases having trismus due to a premalignancy has been presented. It is hypothesized that the same appliance can be used for treating inoperable trismus in palliative care setting additionally or as an adjuvant to pharmacological approach.
ABSTRACT
INTRODUCTION: Oral mucositis is an unavoidable complication occurring during the treatment of cancer by radiotherapy, concurrent chemoradiotherapy (CCRT), or chemotherapy. This is a painful sequelae, significantly affecting the nutritional intake and quality of life. MATERIALS AND METHODS: A multicentric cross-sectional study was done at four cancer centers in Hyderabad. About 455 subjects of both genders between 20 and 80 years undergoing cancer treatment such as chemotherapy (Group I), CCRT (Group II), radiotherapy within 14 days of initiation (Group III), and radiotherapy after 14 days of initiation of therapy (Group IV) who had oral mucositis were included in the study. A self-addressed Hospital Anxiety and Depression Scale questionnaire was used to assess the anxiety/depression in cancer therapy-induced oral mucositis patients. RESULTS: Group III had established anxiety (58.82%) followed by Group IV (47.5%) of patients showing severe oral mucositis. In Group I, 47.17% and in Group II, 40% patients with borderline anxiety had mild mucositis, which was statistically significant (P = 0.01). Group III had established depression in 56.36%, followed by Group IV with 39.62% patients showed severe oral mucositis. Group I and II had mild to moderate mucositis, which was associated with established depression at statistically significant result (P = 0.02). CONCLUSION: Group IV had maximum participants with anxiety and depression, closely followed by Group II, Group III, and least in Group I. Thus appropriate intervention in the form of nonpharmacological and pharmacological treatment is warranted.
