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     A Brief Guide on Microstomia Micro + Stomia  =  Small + Mouth Opening

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

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.                        

MEET RAFAEL! Rafael is using the DynaCleft® pre-operative positioning system for improved functional and cosmetic surgical outcomes. Cleft lip and palate is the most common craniofacial abnormality.

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.

Confirmed!! New research reinforces the effectiveness of the DynaCleft System with Nasal Elevators for presurgical infants with unilateral cleft lip and palate. 

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

                  

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.

CranioRehab is proud to be a sponsor of the myFace RACES FOR FACES virtual walk. This important fundraising event helps raise awareness for children and adults with facial differences. This year's walk, on September 26, 2020, has gone virtual- so anyone, anywhere, can join in! https://p2p.onecause.com/racesforfaces/team/craniorehab

DynaClose strips are designed to close skin defects up to 5cm in width. The strips are clear elastomeric anchored by an adhesive fabric tape on either side. They provide an easy and non-invasive method to close retracted or dehisced wounds.

DynaStretch strips are designed to provide external pre-surgical skin expansion over an area of planned excision up to 5cm wide. New surplus skin may be consistent with the surrounding tissue and can be used to span a tissue defect created by surgical excision.

SutureSafe is an improvement over static tape to support closed wounds, particularly for areas of increased movement. 

It dynamically bridges and supports closure of surgical incisions, allowing a cushion of skin movement while still pulling

the wound margins together with gentle appositional traction. 

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,

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

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!

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.  

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?

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, ML, Lazarus, CL, Ru, 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! 

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. 

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. 

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). 

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.

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. 

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.

The study “Full thickness facial burns: Outcomes following orofacial rehabilitation” (2015) examines the impact of orofacial rehabilitation on full thickness orofacial burn, specifically looking at mouth opening range vertically and horizontally. Results indicated that rehabilitation, including use of the OraStretch press or TheraBite device, had a positive effect on patients' opening range.