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#192453 05-27-2016 06:25 AM
Joined: Dec 2011
Posts: 126
emilyp Offline OP
Senior Member (100+ posts)
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Senior Member (100+ posts)

Joined: Dec 2011
Posts: 126
Hi Guys,

I was hoping I could pick your brain about a concern I have. As a result of my surgery and radiation, I have very limited tongue movement, and cannot stick my tongue out past the inside of my teeth. Consequently, I compensate for this limitation by moving my bottom jaw a lot to talk and eat. I like to joke that I eat like a cow, moving my bottom jaw in a circular motion. However, I am concerned what the long term effects of this will be to my jaw. Currently, my jaw often makes very large popping noises often when eating, especially when eating chewy foods (I am guessing this is TMJ). I know this can't be good, but I don't know how else I can eat/talk. Does anyone else have long term issues with their jaw? My jaw currently doesn't ever hurt, but I am worried that this is just going to get worse. If anyone has any similar issues, is there anything I need to prepare for, or anything I can do to prevent it from getting worse? I have scheduled an appointment to get an evaluation by my speech therapist, as well as undergo a swallow study (just to make sure everything is still working fine), but I figured I would ask y'all as well.

Thanks!
Emily


Emily - 24 years old at diagnosis
HPV-, no risk factors
T2N2b Squamous Cell Carcinoma
Left oral tongue, poorly differentiated
Hemiglossectamy, reconstruction, partial neck dissection
30 Radiation treatments, weekly chemo (cisplatin)
1/13/12 last day of treatment
Diagnosed October 2011
Joined: Dec 2003
Posts: 2,606
Likes: 2
Patient Advocate (old timer, 2000 posts)
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Patient Advocate (old timer, 2000 posts)

Joined: Dec 2003
Posts: 2,606
Likes: 2
Emily, my jaw has popped lik that for close to 9 years now. I think my bite got misaligned as bruxism got worse and chewing tries to correct it. I look around to see if anyone notices it when the sound is particularly loud. My jaw gets sore sometimes when I chew too long.


SCC Stage IV, BOT, T2N2bM0
Cisplatin/5FU x 3, 40 days radiation
Diagnosis 07/21/03 tx completed 10/08/03
Post Radiation Lower Motor Neuron Syndrome 3/08.
Cervical Spinal Stenosis 01/11
Cervical Myelitis 09/12
Thoracic Paraplegia 10/12
Dysautonomia 11/12
Hospice care 09/12-01/13.
COPD 01/14
Intermittent CHF 6/15
Feeding tube NPO 03/16
VFI 12/2016
ORN 12/2017
Cardiac Event 06/2018
Bilateral VFI 01/2021
Thoracotomy Bilobectomy 01/2022
Bilateral VFI 05/2022
Total Laryngectomy 01/2023
Joined: Jul 2012
Posts: 3,267
Likes: 1
Patient Advocate (old timer, 2000 posts)
Offline
Patient Advocate (old timer, 2000 posts)

Joined: Jul 2012
Posts: 3,267
Likes: 1
I had TMJ more than 20 years before cancer, but now it's worse, besides the trismus from treatment, fibrisism when last measured the mouth opening was about 12mm. I've seen several SLP's, been through their boot camp, and did the exercises, which should be lifelong, and can impact eating, speaking, oral care, besides anesthesia options, as you already may know. There is the Therabyte that may help some, but heard Dynasplint is better. I used used my thumb and index finger crossed vs some using stacked tongue depressors, which is better directed by the SLP, if so directed. I assume you were referred to an SLP, and other reasons for TMJ/Trismus were ruled out by your medical team even though out several years from treatment.

Good luck


10/09 T1N2bM0 Tonsil
11/09 Taxo Cisp 5-FU, 6 Months Hosp
01/11 35 IMRT 70Gy 7 Wks
06/11 30 HBO
08/11 RND PNI
06/12 SND PNI LVI
08/12 RND Pec Flap IORT 12 Gy
10/12 25 IMRT 50Gy 6 Wks Taxo Erbitux
10/13 SND
10/13 TBO/Angiograph
10/13 RND Carotid Remove IORT 10Gy PNI
12/13 25 Protons 50Gy 6 Wks Carbo
11/14 All Teeth Extract 30 HBO
03/15 Sequestromy Buccal Flap ORN
09/16 Mandibulectomy Fib Flap Sternotomy
04/17 Regraft hypergranulation Donor Site
06/17 Heart Attack Stent
02/19 Finally Cancer Free Took 10 yrs






Joined: Dec 2011
Posts: 126
emilyp Offline OP
Senior Member (100+ posts)
OP Offline
Senior Member (100+ posts)

Joined: Dec 2011
Posts: 126
Thanks for the info! I initially had trismus after radiation, but using the stacked tongue depressors technique really helped eliminate the issue quickly. I met with my speech pathologist, and she did not seem too concerned, as long as it is not causing pain. I did learn though that my tongue/swallowing has gotten a bit weak (although luckily I am not aspirating), so she gave me some good exercises to do to try and strengthen my tongue muscles and prevent the leaking. 3 days into my exercises, I've already noticed I have been able to stick out my tongue a bit further, which is exciting.

She also referred me to a prosthodontist to see if I would be a good candidate for a retainer which would basically extend the roof of my mouth to possibly make eating and talking a little easier (as I have some trouble touching my tongue to the roof of my mouth). If this works, I am hoping it could help my jaw issue as well, as it may make it easier to talk/chew without relying as much on my jaw movement. Have any of you tried this yet?

Thanks!


Emily - 24 years old at diagnosis
HPV-, no risk factors
T2N2b Squamous Cell Carcinoma
Left oral tongue, poorly differentiated
Hemiglossectamy, reconstruction, partial neck dissection
30 Radiation treatments, weekly chemo (cisplatin)
1/13/12 last day of treatment
Diagnosed October 2011

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