Case Study – Trismus

October 13, 2017 | By | Reply

Trismus, also called Lockjaw, is a condition which causes reduced opening of the jaw. It may be caused by spasms of the muscles of mastication, or a variety of other causes such as Temporomandibular Joint (TMJ) disorder, trauma, chemotherapy/radiotherapy, oral cancer or dental treatment.

A 42-year-old male patient developed trismus post radiation therapy for oral carcinoma. He came to us with mouth opening limited to 18mm. This led to:

  • difficulty in speaking and chewing
  • compromised oral hygiene
  • difficulty swallowing

O/O – post-radiation pigmentation on neck

O/P – tenderness on Right TMJ, mandible and mastoid

Active movements:

  • Mouth opening: 18 mm, with deviation to right.
  • Tongue protrusion: deviation to right
  • Jaw Protrusion: 1 mm
  • Lateral deviation: 4mm  to each side

Resisted isometrics:

  • Mouth opening: weak
  • Closing : weak
  • Lateral deviation (R) strong (L) weak

Joint play:

  • Longitudinal caudad, lateral glide, medial glide, posterior glide: all were hypomobile on the right side.

Rx given:

  1. Glides to TMJ: longitudinal caudad, lateral and medial glide, posterior glide
  2. Soft tissue release around masseter, temporalis, pterygoids
  3. Neck stretches
  4. Strengthening exercises of mouth, of muscles around TMJ
  5. Contract relax to mouth opening and closing
  6. Active tongue protrusion and deviations
  7. Active mouth opening, protrusion and deviations
  8. Passive stretch using instruments

Post Rx:

  • After taking therapy for 3-4 months, now the mouth opening has reached 24mm. Patient finds improvement in talking, chewing, swallowing and is able to maintain oral hygiene.

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Category: Case Studies

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