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Recent
Topics being discussed on the Oncology Section Member Listserve:
Question: I have a pt who has had base of tongue CA and has had a lot of radiation. She has a max opening of the mouth of 20 mm, and I can stretch her to 25 mm, w/ intra-oral mobilization. She is not limited in lateral excursion, and has good protrusion. The TMJ capsule is very stiff w/ a hard end feel. Wondering if anybody has any other ideas as how to help this pt get more functional opening. She is doing self stretching of course. She has no real pain with stretching, and there is no muscle guarding. I am assuming this is a normal response to radiation, and wondering what the long term functional opening for these patients is.LB
Response:
I remember reading a case study last year about a tongue cancer survivor being helped by ASTYM. See article below for more specific details. http://oralcancernews.org/wp/2008/02/opening-up-innovative-physical-therapy-helps-keep-cancer-survivor/ AG
Unfortunately it is common to have TMJ restriction following radiation on the face due to the fibrosis of tissues around the joint. Opening seems to be more restricted than lateral excursion because it involves so much more glide of the mandibular head in the joint than needed for lateral excursion. Prognosis for much more improvement in opening is guarded depending on the severity of fibrosis. Please use caution in stretching the joint as radiated tissues can be fragile and you don't want to tear soft tissues nor fracture the mandible. Slow, easy and gentle. JW
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Other
Topics being discussed on the Oncology Section Member Listserve:
- Does performing Manual Lymphatic Drainage (MLD) massage
HEP cause hot flashes?
- Treatment
of chemotherapy induced peripheral neuropathy
- Manual
lymphatic drainage (MLD) massage
- Looking
for data on rates of lymphedema in non-breast cancer patients
- Contraindications
for Anodyne
- ...and much more
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