{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T00:37:06Z","timestamp":1778891826618,"version":"3.51.4"},"reference-count":26,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2017,5,29]],"date-time":"2017-05-29T00:00:00Z","timestamp":1496016000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003748","name":"Svenska S\u00e4llskapet f\u00f6r Medicinsk Forskning","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003748","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005009","name":"Stiftelsen Assar Gabrielssons Fond","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005009","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007230","name":"Stiftelsen Konung Gustaf V:s Jubileumsfond","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007230","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["P30 CA008748"],"award-info":[{"award-number":["P30 CA008748"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Otolaryngology"],"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To identify temporal patterns of patient\u2010reported trismus during the first year post\u2010radiotherapy, and to study their associations with maximal interincisal opening distances (<jats:styled-content style=\"fixed-case\">MIO<\/jats:styled-content>s).<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Single institution case series.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>University hospital <jats:styled-content style=\"fixed-case\">ENT<\/jats:styled-content> clinic.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>One hundred and ninety\u2010six subjects who received radiotherapy (<jats:styled-content style=\"fixed-case\">RT<\/jats:styled-content>) for head and neck cancer (<jats:styled-content style=\"fixed-case\">HNC<\/jats:styled-content>) with or without chemotherapy in 2007\u20102012 to a total dose of 64.6\/68\u00a0Gy in 38\/34 fractions, respectively. All subjects were prospectively assessed for mouth\u2010opening ability (Gothenburg Trismus Questionnaire (<jats:styled-content style=\"fixed-case\">GTQ<\/jats:styled-content>), European Organization for Research and Treatment of Cancer quality of life Questionnaire (EORTC QLQ\u2010H&amp;N35), and <jats:styled-content style=\"fixed-case\">MIO<\/jats:styled-content>) pre\u2010<jats:styled-content style=\"fixed-case\">RT<\/jats:styled-content> and at 3, 6 and 12\u00a0months after <jats:styled-content style=\"fixed-case\">RT<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Correlations between temporally robust <jats:styled-content style=\"fixed-case\">GTQ<\/jats:styled-content> symptoms and <jats:styled-content style=\"fixed-case\">MIO<\/jats:styled-content> as given by Pearson's correlation coefficients (<jats:italic>P<\/jats:italic><jats:sub><jats:italic>r<\/jats:italic><\/jats:sub>); temporally robust <jats:styled-content style=\"fixed-case\">GTQ<\/jats:styled-content>\u2010symptom domains as given by factor analysis; rates of trismus with respect to baseline by risk ratios (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content>s).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Four temporally robust domains were identified: <jats:italic>Eating<\/jats:italic> (3\u20107 symptoms), <jats:italic>Jaw<\/jats:italic> (3\u20107), <jats:italic>Pain<\/jats:italic> (2\u20105) and Quality of Life (<jats:italic>QoL<\/jats:italic>, 2\u20105), and included 2\u20103 persistent symptoms across all post\u2010<jats:styled-content style=\"fixed-case\">RT<\/jats:styled-content> assessments. The median <jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content> for a moderate\/severe (&gt;2\/&gt;3) cut\u2010off was the highest for <jats:italic>Jaw<\/jats:italic> (3.7\/3.6) and <jats:italic>QoL<\/jats:italic> (3.2\/2.9). The median <jats:italic>P<\/jats:italic><jats:sub><jats:italic>r<\/jats:italic><\/jats:sub> between temporally robust symptoms and <jats:styled-content style=\"fixed-case\">MIO<\/jats:styled-content> post\u2010radiotherapy was 0.25\u20100.35\/0.34\u20100.43\/0.24\u20100.31\/0.34\u20100.50 for <jats:italic>Eating<\/jats:italic>\/<jats:italic>Jaw<\/jats:italic>\/<jats:italic>Pain<\/jats:italic>\/<jats:italic>QoL<\/jats:italic>, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Mouth\u2010opening distances in patients with <jats:styled-content style=\"fixed-case\">HNC<\/jats:styled-content> post\u2010<jats:styled-content style=\"fixed-case\">RT<\/jats:styled-content> can be understood in terms of associated patient\u2010reported outcomes on trismus\u2010related difficulties. Our data suggest that a reduction in <jats:styled-content style=\"fixed-case\">MIO<\/jats:styled-content> can be expected as patients communicate their mouth\u2010opening status to interfere with private\/social life, a clinical warning signal for emerging or worsening trismus as patients are being followed after <jats:styled-content style=\"fixed-case\">RT<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/coa.12896","type":"journal-article","created":{"date-parts":[[2017,5,2]],"date-time":"2017-05-02T15:01:48Z","timestamp":1493737308000},"page":"22-30","source":"Crossref","is-referenced-by-count":11,"title":["Temporal patterns of patient\u2010reported trismus and associated mouth\u2010opening distances in radiotherapy for head and neck cancer: A prospective cohort study"],"prefix":"10.1111","volume":"43","author":[{"given":"M.","family":"Thor","sequence":"first","affiliation":[{"name":"Department of Medical Physics Memorial Sloan Kettering Cancer Center New York NY USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C. E.","family":"Olsson","sequence":"additional","affiliation":[{"name":"Department of Radiation Physics Institute of Clinical Sciences The Sahlgrenska Academy at the University of Gothenburg Gothenburg Sweden"},{"name":"Regional Cancer Center West The Western Sweden Healthcare region Gothenburg Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. H.","family":"Oh","sequence":"additional","affiliation":[{"name":"Department of Medical Physics Memorial Sloan Kettering Cancer Center New York NY USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Hedstr\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery Institute of Clinical Sciences The Sahlgrenska Academy at the University of Gothenburg Gothenburg Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N.","family":"Pauli","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery Institute of Clinical Sciences The Sahlgrenska Academy at the University of Gothenburg Gothenburg Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Johansson","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery Institute of Clinical Sciences The Sahlgrenska Academy at the University of Gothenburg Gothenburg Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. 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