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PubMed1991

[Restricted mouth opening as a leading symptom of trismus-pseudocamptodactyly syndrome].

In the absence of pain or dental findings, incapacity to open the mouth fully, concomitant with a typical restriction of movement of the fingers is defined as the trismus-pseudocamptodactyly syndrome. This autosomal dominantly inherited feature is quite rare. So far only affections of families in the USA, the Netherlands, Canada and, recently, Japan, have been reported in the literature. Now, a German case affecting six members of the same family has been found for the first time. An important factor to be considered in the differential diagnosis of painless chronic trismus, this syndrome is described here.

Abnormalities, Multiple↗
PubMed1990

A randomized double-blind clinical trial on the effectiveness of helium-neon laser in the prevention of pain, swelling and trismus after removal of impacted third molars.

The effect of helium-neon (He-Ne) laser on the prevention of pain, swelling and trismus following the removal of an impacted third molar was studied in 100 patients randomly allocated to receive He-Ne laser, ibuprofen or placebo in a prospective double-blind parallel clinical trial. Trismus was significantly reduced in the He-Ne laser and ibuprofen treatment groups. Pain was significantly less in the ibuprofen group with regard to He-Ne laser and placebo groups. Swelling was the same in the three treatment groups.

Adult↗
PubMed1995

Nursing care of the patient with trismus.

This paper discusses trismus (mandibular hypomobility), addressing its etiologies, relevant anatomy and pathophysiology, with the medical and nursing care of trismic patients commonly seen in the otolaryngology setting. It aims to raise awareness among ORL nurses about the sometimes subtle presentation of trismus and about the important role ORL specialists can play in detecting and treating this debilitating disorder.

Humans↗
PubMed1996

[Trismus disclosing Horton's disease].

The authors report a giant cell arteritis case associating trismus and hemifacial oedema in a febrile context. After spontaneous regression of other manifestations, the apparition of more typical signs allowed to associate the diagnosis of temporal arteritis, later confirmed histologically. Thus, when facing a trismus case, even more when fever is present, it seems important to associate with the Horton's disease, no matter what the antecedents found at the interrogatory be, whether initial or isolated. The Doppler reveals flux abnormalities of the superficial branches of the external carotid. The examination of facial, temporal and internal maxillary arteries has a good negative predictive value in this pathology. It would be useful in therapeutic supervision.

Biopsy↗
PubMed1995

The use of a dynamic opening device in the treatment of radiation induced trismus.

A commonly observed sequela of radiation therapy for malignancy of the head and neck is trismus. Patients may experience a marked restriction of jaw opening and overall mobility, which is of great concern and lessens the quality of life. A 66 year old edentulous man experiencing radiation therapy induced trismus was treated with a dynamic opening device to improve his opening and range of movement, before new maxillary and mandibular complete dentures were constructed for him.

Aged↗
PubMedDate not supplied

Trismus: causes, differential diagnosis, and treatment.

Successful treatment of trismus depends upon prompt recognition of its cause and the initiation of appropriate management. Otherwise, trismus may lead to permanent functional impairment. Differential diagnosis and modes of treatment are reviewed.

Diagnosis, Differential↗
PubMed1988

Anaesthetic implications of the trismus pseudocamptodactyly (Dutch-Kentucky or Hecht Beals) syndrome.

The trismus pseudocamptodactyly syndrome is a relatively rare, autosomal dominant condition first described in 1969. Affected patients classically present with two main features: limited excursion of the mandible and flexion deformity of the fingers that occurs with wrist extension (pseudocamptodactyly). Foot deformities and a shorter-than-normal stature may also be present. The underlying abnormality is short muscle tendon units, which prevent normal growth and development. We reviewed the anaesthetic experience in three paediatric patients with the trismus pseudocamptodactyly syndrome and the pertinent clinical findings in three other members of the same family, spanning three generations. Limited mandible excursion was present in all six cases, but was not obvious preoperatively in the patients because of its subtle presentation. All three cases were successfully managed using mask anaesthesia with spontaneous ventilation, avoiding muscle relaxants. Attempts to visualize the larynx under anaesthesia were unsuccessful in two cases. Blind nasotracheal intubation was successful in one patient. Postoperatively, there were no problems with the airway.

Adult↗
PubMed1985

Trismus. An unusual sign in polymyositis.

Neuromuscular disease is an unusual cause of trismus. However, we describe two patients with severe polymyositis who had difficulty opening their mouths during the acute phase of the illness. Electromyography demonstrated involvement of the masseters, and there was no evidence of myasthenia. The mechanism appeared to be decreased elasticity of the masseter because of inflammation, edema, and perhaps contractures.

Adult↗
PubMed1982

Linkage analysis with the trismus-pseudocamptodactyly syndrome.

In 6 generations of a family with the trismus-pseudocamptodactyly syndrome (TPS), we identified 53 affected individuals, 33 females and 23 males. Thirty-one of the 53 were personally examined, as were 77 unaffected relatives. The clinical findings are compared with those of previous reports. Severity of expression is highly variable, but reduced penetrance was not observed. We obtained blood specimens for linkage analysis on all 108 examined individuals. Linkage could be excluded for 16 polymorphic marker loci. The largest positive lod scores were for the BF and AK1 marker systems, being 0.9 and 0.6, respectively. Since BF and AK1 are on different chromosomes (6 and 9, respectively), these results do not indicate a location for the TPS gene.

Child, Preschool↗
PubMed2006

Coronoidotomy as treatment for trismus due to jaw-closing oromandibular dystonia.

Oromandibular dystonia is a focal dystonia involving the masticatory and/or tongue muscles. This report describes 2 female patients with jaw-closing dystonia treated by surgical resection of the coronoid process. The patients could not open their mouths due to involuntary jaw-closing muscle contraction. We first treated them by injecting lidocaine and alcohol (muscle afferent block) into the masseter and temporal muscles and then botulinum toxin. However, the trismus improved mildly and transitorily. Therefore, coronoidotomy was done under general anesthesia. The jaw opening increased to 50 mm. Coronoidotomy is useful for patients with jaw-closing dystonia in whom other therapies are ineffective.

Botulinum Toxins, Type A↗
PubMed1984

Trismus and carcinoma of the tonsil.

Carcinoma of the tonsil is the second most common neoplasm of the upper respiratory tract and a sore throat is the most frequent initial symptom. Trismus, which may be an accompanying sign, is only rarely the only presenting symptom. A case is presented.

Carcinoma, Squamous Cell↗
PubMed1985

Trismus in postoperative, posttraumatic and other brain stem lesions caused by paradoxical activity of masticatory muscles.

In fifteen cases of brain stem lesions caused by basal tumours, operations, injuries, arteriosclerosis or multiple sclerosis, a paradoxical activity of jaw closing muscles during jaw opening was observed. This inverse activity was the cause of severe trismus in 8 cases. It is the manifestation of a faulty programming of jaw movements in the trigeminal motor area in brain stem. This distinct new brain stem syndrome can only be detected by EMG investigation. EMG findings, pathological background, outcome and treatment possibilities are discussed in this paper.

Brain Diseases↗
PubMed2005

[Acute aspiration and trismus due to tetanus].

Tetanus is a worldwide health problem, causing the deaths of approximately 1,000,000 people every year. In Germany, about 15 infections are reported annually. The initial symptoms often develop in the head and neck region. As a result, some patients are referred to the otorhinolaryngologist. We report on a 83 year old female who suffered from recurrent aspiration and trismus. She had acquired a small injury on her lower leg 2 weeks earlier; protective antibody levels did not exist. The neurophysiological examination showed a result typical of tetanus. The patient received tetanus immunoglobulin, metronidazole and benzodiazepines. Due to respiratory problems, tracheotomy and ventilation became necessary. Elderly people often lack protective antibody levels against tetanus. If typical symptoms are manifest, tetanus has to be considered as a possibility. A complete history, including recent injuries and past vaccinations, should be compiled.

Acute Disease↗
PubMed1975

Radiologic examination of trismus as a complication of cancrum oris.

In the radiologic examination of trismus complicating cancrum oris, abnormalities can be detected in the soft tissues, osseous tissues, and temporomandibular joint. In the soft tissue, scar formation may show as a depression in the normal smooth, convex contour of the lateral aspect of the face. There may be a myositis ossificans in the soft tissue, producing bony bars that lead to extra-articular ankylosis. By far the most important changes are in the temporomandibular joint, where there can be varying degrees of joint narrowing, sclerosis of the articular cortex, flattening of the mandibular condyle and occasionally also of the eminentia articularis, osteophytosis, and intra-articular bony ankylosis. Hypoplasia may involve the entire hemimandible or be restricted to its condyloid process. The latter may lead to compensatory enlongation and hypertrophy of the coronoid process. Bony ankylosis of the coronoid process to the posterior wall of the maxilla was seen in three cases. The pathogenesis of these changes is discussed.

Adolescent↗
PubMed1979

An unusual case of trismus.

Described is a case in which a patient suffered multiple facial injuries resulting in significant trismuss. Many extracapsular factors have been reported to results in trismus. Most common are those involving the coronoid process and fibrous tissue adhesions of associated structures. This case involves a situation in which multiple foreign-body fragments led to this patient's being unable to open his mouth adequately.

Adult↗
PubMed1986

An intraoral positive-pressure device for treatment of trismus.

Trismus is a challenging clinical problem that may result from several different causes. The dentist may choose from a wide spectrum of treatment modalities, depending on the severity of the individual case and the health and cooperation of the patient. An individual course of treatment must be planned for each patient. It is important to monitor the treatment closely for effectiveness of the therapy and to ensure the patient's compliance. Treatment should be modified as necessary, according to the patient's progress. We have described an intraoral dynamic device that may be used as part of a treatment program and that enhances patient compliance as compared to traditional extraoral devices.

Equipment Design↗