An Update on Lymphedema Management in HNC

Discussion of a recent blog post, by Dr. Ron J. Karni, addressing updates in lymphedema treatment, in particular, using the advance pneumatic compression device. 
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Expand Your HNC Rehab Toolkit

Solutions for trismus, microstomia, xerostomia, dysphagia and more!
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NEW PRODUCTS! Microstomia & OroFacial Scarring

NEW PRODUCTS! The OraFlex™ MPA for the prevention and treatment of microstomia & the OraPlace Tools for the prevention and treatment of orofacial scarring                           
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What is Microstomia

     A Brief Guide on Microstomia Micro + Stomia  =  Small + Mouth Opening
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Fighting Trismus with a Better Fit! OraStretch Press Sizes

Fighting Trismus with a Better Fit! OraStretch Press Sizes

The OraStretch press  is available in 5 versions to better fit your patients' needs!
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How to Measure MIO

Mouth opening is measured as a MIO or ROM distance. MIO (maximal interincisal 

opening) is the distance between the central incisors when the mouth is fully open. 

Average MIO for adults is approx. 50mm. By measuring MIO, a therapist can determine

if a patient is WNL or has trismus. ROM (Range-of-Motion) is the maximum distance

the mandible moves. ROM and MIO may be different, e.g. patients with an open bite.                        
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Dysphagia and the Tongue


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Trismus in HNC Patients - 2020 Update

80-90% of patients with radiation to the pterygoid and/or masseter muscles will develop trismus.  Learn how to diagnose and treat including therapy with the OraStretch press jaw motion rehab system.
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Tongueometer Bluetooth Device Now Available!

BIG NEWS! Tongueometer Bluetooth device now available for iOS and Android devices. Increase tongue strength and endurance with an easy to use, affordable device. 

                  

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Support Organizations for Head & Neck Cancer & Craniofacial Patients

A review of a few of the wonderful nonprofit organizations within the HNC, dysphagia and craniofacial communities to support patients as they face these challenges.

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Oral Mucositis in HNC Patients

Spring 2020 Newsletter ORAL MUCOSITIS IN HEAD & NECK CANCER PATIENTS Oral Mucositis occurs in up to 80% of HNC irradiated patients! What is oral mucositis (OM)? Mucositis is the inflammation,
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How Strong Is Your Tongue? and Other Fun Facts...

FUN TONGUE FACTS How long is the tongue?  The average tongue is approximately 3 inches in length. According to the Guinness World Records, as of May 2020, the longest tongue record goes to Nick Stoeberl whose tongue measures 3.97
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LEARN & EARN!!! SLP CMH REMOTE IN-SERVICE: Oral Complications of Head & Neck Cancer Care -- Trismus, Xerostomia, Mucositis & Dysphagia

Earn .1 CMH (1 hour) towards ASHA requirements with a remote live in-service.

Speech pathologist, Sarah Schuman, is providing a free in-service on trismus, xerostomia, mucositis and dysphagia in HNC cancer patients. The in-service takes approximately 1-hour and you will have the ability to ask all of your HNC rehab questions!

Please contact us via email to [email protected] or call us at 1-800-206-8381 ext 86 for scheduling.

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Saliva and Xerostomia in the HNC Patient

Head & neck cancer patients often develop acute and chronic xerostomia and dry mouth.  Learn more about the causes, diagnosis, and treatment of xerostomia and dry mouth.  
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The Psychological Burden of HNC Survivorship on Patients and Caregivers

An often neglected burden of HNC survivorship is that on the psychological effects of head and neck cancer on both the patients and caregivers. How can we, the providers, help?

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New Research! When is it best to start trismus therapy?

When is it best to start trismus therapy? Treatment for head and neck cancer may cause trismus, xerostomia and dysphagia negatively impacting a patient's quality of life (QOL).  A new study, Effects of jaw exercise intervention timing on outcomes following oral and oralpharyngeal cancer surgery: Pilot study (Sandler, MLLazarus, CLRu, M, et al, 2019), looks at the optimal timing for exercise initiation post-operatively in HNC patients. Initial findings suggest early exercise intervention has a positive effect on some QOL measures! 
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Radiation Fibrosis - Development & Impact in HNC Patients

Radiation, commonly used in the treatment of head and neck cancer, may negatively affect healthy cells by increasing the production of the protein, fibrin which damages soft tissues in the treatment field potentially leading to trismus, or limited mouth opening. Trismus affects patients negatively by making it difficult to speak, eat, maintain good oral hygiene, receive dental procedures and it even has the potential to complicate intubation. In patients that receive radiation treatments, approximately 30% will develop trismus. If the treatment field includes the pterygoid or masseter muscles incidence rises to above 80%. Loss of maximal interincisal opening (MIO) is continual and progressive in these patients. Therapeutic exercises will need to continue for the rest of the patient's life! The good news is that trismus is preventable and treatable with exercise therapy using jaw motion rehab systems such as the OraStretch press. 
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New Research Reinforces Prevalence of Trismus in HNC Patients up to 10 Years Post Treatment

New Research! Systematic review and meta-analysis reinforces the significant prevalence of trismus (equal to or less than 35 mm MIO) in HNC patients up to 10 years post treatment. 
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HPV Vaccine is Key in Fight Against Cancer

HPV Vaccine In The News!!!!

Published in The Lancet, an important new study demonstrates that vaccines against the human papillomavirus (HPV) are in fact decreasing HPV infections including precancerous cervical lesions and anogenital warts. This study indicates that the HPV vaccine has been more effective than expected, reducing rates of HPV infection in the vaccinated population and FURTHERMORE reducing rates of HPV-related diseases in the non-vaccinated population (herd immunity). 

In June 2019, the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices  approved the use of the HPV vaccine in some people through the age of 45. By expanding the pool of approved people, more insurance providers may cover the vaccine. 
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CranioRehab Update and Research Refresh

CranioRehab Update & Research Refresh. Review "Correlation Between Radiation Dose to Pterygoid and Masseter Muscles with Trismus" and "Successful Rehab of Facial Burns Using Jaw Motion Rehab Systems Including the OraStretch Press". Learn about CranioRehab products.
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Actress Aims to Destigmatize HPV- Related Cancers

In an effort to end the shame surrounding cancers caused by the human papillomavirus (HPV), actress Marcia Cross shares her personal story with anal cancer as well as her husband's with throat cancer. 
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New Research Correlates Radiation Dose to the Masseter and Pterygoid Muscles with the Development of Trismus (Article Review)

Reconfirmed!! New research reinforces the correlation between radiation dose to the masseter and pterygoid muscles with the development of trismus.


The study “Radiation dose to the masseter and medial pterygoid muscle in relation to trismus after chemoradiotherapy for advanced head and neck cancer” stresses the impact of radiation dose on the ipsilateral masseter muscle and the ipsilateral medial pterygoid muscle in head and neck cancer patients. A meaningful analysis of data was conducted across 83 patients treated for advanced squamous cell carcinoma of the head and neck. These patients participated in a preventive exercise program for mouth opening and MIO measurements were compared. The study concluded that radiation dose on the ipsilateral masseter muscle and ipsilateral medial pterygoid muscle is predictive for trismus.


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Xerostomia in HNC Patients

Xerostomia, "dry mouth" is due to reduced or absent saliva production. It may affect a patient's quality of life and can lead to serious health problems! Learn about the signs, symptoms and managing xerostomia. 
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Living with Xerostomia - Mouth Care and Gum Health

Living with Xerostomia? Tried and true tips from cancer survivor Speech Pathologist, Marcy Maksail, for Saliva Substitutes, Mouth and Gum Health.
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IMPORTANT HPV VACCINATION UPDATE!!!

On October 5, 2018, the U.S. Food and Drug Administration (FDA) approved the administration of the Gardasil 9 vaccine for women and men between the ages of 28-45 years. Previously the vaccine was indicated for individuals up to the age of 27 years. "Gardasil 9 prevents certain cancers and diseases caused by the nine HPV types covered by the vaccine". Human Papilloma Virus (HPV) can cause head and neck cancer in men and women. It is the cause of most oropharyngeal cancers in United States. These cancers and their treatment may lead to trismus (limited mouth opening) and dysphagia (difficulty swallowing). 

The expansion in vaccination ages follows a study in which 3,2000 women between the ages 27-45 years were followed for approximately 3.5 years and it was found that Gardasil was 88% effective in preventing certain HPV related infections and cancers. The results were inferred to apply to men as well.

For further information, please see the complete FDA News Release at: https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm622715.htm
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