Head and Neck Cancer

Trismus is a condition in which someone has difficulty opening their mouth.

Trismus can develop:

• If a tumor involves the muscles and nerves that open the mouth
• After surgery to the head and neck
• After radiation therapy to the head and neck

Surgery and radiation therapy can injure the tissues involved in opening the mouth. Fibrosis (scarring) can develop as the tissues begin to heal from surgery. Fibrosis can also build up years after radiation therapy. Muscle and other fibres shorten and tighten, which makes it harder to open your mouth. When you can’t open your mouth well, it is hard for your doctor to examine this area.

You may also have problems:

• Cleaning your mouth and teeth. This may lead to bad breath, cavities, and infections
• Chewing and swallowing. This can make it difficult for you to eat and drink
• Talking
• Kissing
• Having a breathing tube placed, if you ever need general anesthesia (medication to make you sleep during a surgery or procedure)
• Having routine dental treatment

Once trismus develops, it is very hard to treat. Prevention and early treatment
are the goals.

Treatment/prevention can involve regular jaw exercises and sometimes use of a device called a TheraBite. Your speech and language therapist can advise whether this is suitable for you.

• Jaw problems after head and neck cancer treatment
• Trismus patient education
• TheraBite® Guidelines

A laryngectomy is the surgical removal of the voice box (larynx) as a treatment for cancer.

After the surgery you will speak and breathe in a different way.

There will be lots of support available from the healthcare team looking after you,
before and after your surgery.

• Living with a laryngectomy stoma
• Caring for a stoma and voice prosthesis after a total laryngectomy

A tracheostomy tube is a small tube that is inserted into the neck that sits inside the windpipe, providing more direct access to the lungs.

It is inserted to help you breathe by allowing a direct route to the lungs, enable suctioning to help remove secretions (phlegm) from the lungs, and stop saliva going into the airway.

Some patients will require a tracheostomy as part of their surgery for head and neck cancer or because of breathing difficulties caused by their cancer before treatment.

• Further advice relating to tracheostomy can be found here
• Read further information about the impact that your tracheostomy may be having, the support that you will receive from the Speech and Language Therapy team, and the stages of a tracheostomy being removed