Avaliação longitudinal do tratamento do câncer de cabeça e pescoço na amplitude eletromiográfica dos músculos masseter, temporal e esternocleidomastoideo durante o repouso mandibular e deglutição
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Data
2022-09-01
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Universidade Estadual Paulista (Unesp)
Resumo
A compreensão da biomecânica muscular em pacientes submetidos ao tratamento oncológico pode ser auxiliada pelo estudo da atividade elétrica dos músculos e mobilidade mandibular. Desse modo, o objetivo deste estudo observacional do tipo série de casos, foi avaliar a influência do tratamento do câncer de cabeça e pescoço na amplitude eletromiográfica dos músculos da face e na mobilidade mandibular. Para isso, foram selecionados sete pacientes com diagnóstico de câncer de cabeça e pescoço. A amplitude eletromiográfica foi verificada nos músculos masseter, temporal e esternocleidomastoideo, na condição de repouso e deglutição, utilizando um eletromiógrafo de superfície. A mobilidade mandibular foi verificada por meio da mensuração da abertura bucal e da aplicação do Questionário de Trismo de Gothenburg (GTQ). Todos os pacientes foram submetidos a análise inicial (T0 – após a determinação do diagnóstico) sendo as demais análises realizadas de acordo com o tratamento oncológico estabelecido para cada paciente (cirúrgico/T1: Pacientes 1, 2, 3 e 7; quimioterápico/T2: 4, 5 e 6; radioterápico/T3: 5, 6 e 7). Após a cirurgia, grande parte dos músculos estudados, apresentaram diminuição da atividade elétrica na condição de repouso e deglutição. Ao contrário, o tratamento quimioterápico, aumentou a atividade elétrica dos mesmos músculos, nas mesmas condições. A associação do tratamento quimiorradioterápico promoveu diminuição nos valores de eletromiografia. Na presença da lesão (T0) foi observado valores elevados na atividade elétrica na posição de repouso mandibular, em grande parte dos músculos estudados. Um paciente apresentou trismo no período T2, com abertura bucal de 32,95 mm. O questionário GTQ apresentou porcentagem alta no período T0 para o paciente 5 (58,09 %). Nesta série de casos, a amplitude elétrica dos músculos estudados parece ter sido influenciada pela presença do tumor, assim como pelo tratamento oncológico realizado.
The understanding of muscle biomechanics in patients undergoing cancer treatment can be aided by the study of the electrical activity of muscles and mandibular mobility. Thus, the objective of this observational case series study was to evaluate the influence of head and neck cancer treatment on the electromyographic amplitude of the facial muscles and on mandibular mobility. For this, seven patients diagnosed with head and neck cancer were selected. The electromyographic amplitude was verified in the masseter, temporal and sternocleidomastoid muscles, in the resting and swallowing condition, using a surface electromyograph. Mandibular mobility was verified by measuring mouth opening and applying the Gothenburg Trismus Questionnaire (GTQ). All patients were submitted to the initial analysis (T0 - after diagnosis was determined) and the other analyzes were performed according to the cancer treatment established for each patient (surgical/T1: Patients 1, 2, 3 and 7; chemotherapy/T2: 4, 5 and 6; radiotherapy/T3: 5, 6 and 7). After surgery, most of the muscles studied showed a decrease in electrical activity in the condition of rest and swallowing. On the contrary, the chemotherapy treatment increased the electrical activity of the same muscles, under the same conditions. The association of chemoradiotherapy treatment promoted a decrease in electromyography values. In the presence of the lesion (T0), high electrical activity values were observed in the mandibular rest position, in most of the muscles studied. One patient presented trismus in the T2 period, with a mouth opening of 32.95 mm. The GTQ questionnaire showed a high percentage in the T0 period for patient 5 (58.09%). In this series of cases, the electrical amplitude of the muscles studied seems to have been influenced by the presence of the tumor, as well as by the oncological treatment performed.
The understanding of muscle biomechanics in patients undergoing cancer treatment can be aided by the study of the electrical activity of muscles and mandibular mobility. Thus, the objective of this observational case series study was to evaluate the influence of head and neck cancer treatment on the electromyographic amplitude of the facial muscles and on mandibular mobility. For this, seven patients diagnosed with head and neck cancer were selected. The electromyographic amplitude was verified in the masseter, temporal and sternocleidomastoid muscles, in the resting and swallowing condition, using a surface electromyograph. Mandibular mobility was verified by measuring mouth opening and applying the Gothenburg Trismus Questionnaire (GTQ). All patients were submitted to the initial analysis (T0 - after diagnosis was determined) and the other analyzes were performed according to the cancer treatment established for each patient (surgical/T1: Patients 1, 2, 3 and 7; chemotherapy/T2: 4, 5 and 6; radiotherapy/T3: 5, 6 and 7). After surgery, most of the muscles studied showed a decrease in electrical activity in the condition of rest and swallowing. On the contrary, the chemotherapy treatment increased the electrical activity of the same muscles, under the same conditions. The association of chemoradiotherapy treatment promoted a decrease in electromyography values. In the presence of the lesion (T0), high electrical activity values were observed in the mandibular rest position, in most of the muscles studied. One patient presented trismus in the T2 period, with a mouth opening of 32.95 mm. The GTQ questionnaire showed a high percentage in the T0 period for patient 5 (58.09%). In this series of cases, the electrical amplitude of the muscles studied seems to have been influenced by the presence of the tumor, as well as by the oncological treatment performed.
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Palavras-chave
Neoplasias de cabeça e pescoço, Radioterapia, Quimioterapia adjuvante, Eletromiografia, Head and neck neoplasms