Background Trismus, or limitation of mouth opening, is a common and debilitating toxicity affecting 23%–28% of head and neck cancer (HNC) survivors treated with radiotherapy. Beyond its classification as a treatment-related adverse event, trismus represents a substantial survivorship burden with profound impacts on nutrition, communication, oral hygiene and quality of life (QoL). This review synthesises evidence on trismus from a rehabilitation and functional recovery perspective, emphasising its relevance to long-term cancer survivorship care. Clinical relevance Trismus significantly impairs activities of daily living and is associated with reduced nutritional intake, speech intelligibility, oral care capacity and psychosocial well-being. Current evidence demonstrates that early, structured rehabilitation interventions can substantially reduce trismus incidence, improve functional outcomes and enhance QoL, yet trismus remains inadequately integrated into standard HNC survivorship protocols. Key management strategies Prevention through prophylactic jaw exercises during treatment, conservative exercise-based rehabilitation, device-assisted therapy (TheraBite) and adjunctive pharmacological approaches represent first-line rehabilitation strategies. Surgical interventions are reserved for severe, refractory cases. A multidisciplinary rehabilitation model integrating radiation oncologists, surgeons, physiotherapists, speech-language pathologists, dietitians and psychologists optimises functional recovery. Future directions Standardised rehabilitation protocols, integration of telehealth approaches for adherence support, expansion of evidence in resource-limited settings and investigation of anti-fibrotic pharmacological agents warrant priority in future research. Recognition of trismus as a modifiable survivorship toxicity with rehabilitation-driven solutions is essential for optimising long-term outcomes in HNC survivors.
Atul Kumar Gupta (Thu,) studied this question.