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<p>Tumor-related resections often resulting in significant functional impairments. This study aims to preliminarily evaluate the impact of adjuvant radiotherapy (RT) on temporomandibular joint (TMJ) function in patients undergoing mandibular resection and reconstruction for malignant lesions. Prospective comparative study. Tertiary care academic medical center. Five patients who underwent mandibular resection and reconstruction followed by RT for malignant tumors were compared with five control patients treated surgically for benign mandibular lesions without RT. TMJ function was assessed at predetermined postoperative intervals using measurements of maximum mouth opening, lateral mandibular movements, and pain intensity scores. Changes in functional parameters were analyzed over time within and between groups. Patients in the RT group experienced a trend toward significant reductions in maximum mouth opening (<i>p</i> &lt; 0.00001) and lateral mandibular movements (<i>p</i> &lt; 0.001879) following completion of treatment. Pain intensity demonstrated a progressive increase, peaking at six months post-RT. Conversely, the control group exhibited stable or modestly improved TMJ mobility with minimal pain. Functional impairments in the RT group were progressive and correlated with time since treatment, suggesting a cumulative adverse effect of radiation on joint structures and masticatory musculature. Adjuvant radiotherapy following mandibular reconstruction may be associated with substantial declines in TMJ mobility and increased pain, indicating compromised functional outcomes compared to patients treated for benign lesions without RT. These findings highlight the importance of early preventative interventions, individualized rehabilitation protocols, and optimization of RT planning to preserve TMJ function. However, due to methodological limitations, including small sample size and unmatched groups, these findings should be interpreted with caution and considered hypothesis-generating. Further research with larger cohorts is warranted to validate these results and inform clinical strategies for mitigating RT-related morbidity.</p>

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Impact of Adjuvant Radiotherapy on Temporomandibular Joint Function Following Mandibular Resection and Reconstruction Assessing TMJ Changes After Radiotherapy

  • 期刊论文

  • 发表日期：

    2026年6月30日

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  • Valerio Zanchi,
  • Beatrice Pulli,
  • Alessandro Serblin,
  • Marco Conti,
  • Giuseppe Spinelli

摘要

Tumor-related resections often resulting in significant functional impairments. This study aims to preliminarily evaluate the impact of adjuvant radiotherapy (RT) on temporomandibular joint (TMJ) function in patients undergoing mandibular resection and reconstruction for malignant lesions. Prospective comparative study. Tertiary care academic medical center. Five patients who underwent mandibular resection and reconstruction followed by RT for malignant tumors were compared with five control patients treated surgically for benign mandibular lesions without RT. TMJ function was assessed at predetermined postoperative intervals using measurements of maximum mouth opening, lateral mandibular movements, and pain intensity scores. Changes in functional parameters were analyzed over time within and between groups. Patients in the RT group experienced a trend toward significant reductions in maximum mouth opening (p < 0.00001) and lateral mandibular movements (p < 0.001879) following completion of treatment. Pain intensity demonstrated a progressive increase, peaking at six months post-RT. Conversely, the control group exhibited stable or modestly improved TMJ mobility with minimal pain. Functional impairments in the RT group were progressive and correlated with time since treatment, suggesting a cumulative adverse effect of radiation on joint structures and masticatory musculature. Adjuvant radiotherapy following mandibular reconstruction may be associated with substantial declines in TMJ mobility and increased pain, indicating compromised functional outcomes compared to patients treated for benign lesions without RT. These findings highlight the importance of early preventative interventions, individualized rehabilitation protocols, and optimization of RT planning to preserve TMJ function. However, due to methodological limitations, including small sample size and unmatched groups, these findings should be interpreted with caution and considered hypothesis-generating. Further research with larger cohorts is warranted to validate these results and inform clinical strategies for mitigating RT-related morbidity.