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Monday, December 9, 2013
Head and Neck Cancer
Scar tissue inside mouth from radiation
This question concerns my father-in-law (age 75) who had cancerous tumor removed from maxillary gland on right side of face as well as part of his palette and several teeth (Apr, 2010) He had intense radiation treatments to insure cancer was gone.(Apr-June, 2010) However, the radiation has left him with such scar tissue on that side of face that limits his ability to open his mouth(app. 4mm opening) let alone eat, drink and makes it almost impossible for him to remove his palette prosthesis to clean. He has undergone two minor surgeries to stretch the tissue which has had no success. Doctors tell him surgery to remove scar tissue is not an option. Is there anything that can be done - Botox or steroid injection into scar tissue? Plastic surgery? Anything to improve his quality of life? Thank you for your help!!
This is a difficult but unfortunately common problem following treatment of oral cavity tumors. What happens is that often surgery and also the postoperative irradiation will damage the muscles and tissues that allow the jaws to move apart from another. Everything scars down and it is difficult to open the jaw. We call this Trismus. Sometimes this can be prevented with aggressive exercise after surgery, during radiation, and early after treatment. Unfortunately the longer we get after treatment the less can be done. There is no successful treatment. The only one is regular stretching either manually of with devices (Therabite). Unfortunately the benefits are often minimal if started when the scarring has already set in. Discuss that with your cancer surgeon.
Pierre Lavertu, MD, FRCS(C), FACS
Professor of Otolaryngology-Head and Neck Surgery
School of Medicine
Case Western Reserve University