Oral cancer is an extremely easy to relapse and grow secondary primary cancer. Nearly 90% of the recurrence cases are in the original lesion area. Doctors point out that long-term chewing of betel nut can easily cause oral submucosal fibrosis. The most critical post-treatment mouth-opening exercises and rehabilitation often make patients worse than death. People with the habit of smoking, drinking, and chewing betel nut are more likely to suffer from oral cancer than the average person. 123 times, and submucosal fibrosis is a precancerous lesion of the oral cavity and should not be underestimated. The General Surgery Department of Xinlou Hospital uses specific surgical methods to treat patients wholeheartedly. More than 95% of patients with intermediate and advanced oral cancer can still open their mouths up to 3 centimeters 8 months after the completion of treatment (including electrotherapy). (Photo provided/Tainan Xinlou Hospital)

Yang Rongwu, chief physician of the Department of Oral and Maxillofacial Surgery at Tainan Xinlou Hospital, said that oral cancer ranks fourth among the top 10 causes of cancer death among men in Taiwan. In the past 40 years, oral cancer has increased among men. The mortality rate has increased fourfold, which is closely related to betel nut chewing, smoking, and drinking.

Most oral cancers in Taiwan are caused by buccal mucosa (skin of the mouth), submucosal fibrosis (hardening of the skin of the mouth) caused by chewing betel nut, scars after surgery, and radiotherapy (electrotherapy). The sequelae will cause the mouth opening to become smaller. In severe cases, patients can even open their mouth less than 1 centimeter after surgery. If the mouth is not opened enough, the doctor will not be able to see clearly. If the patient cannot see clearly, the recurrence of cancer may not be detected and early treatment will be delayed. Therefore, the key factor in tracking the recurrence of oral cancer is the degree of mouth opening. .

In particular, oral submucosal fibrosis is an aggressive, chronic inflammatory fibrosis. Clinical symptoms include burning pain, oral ulcers, dysgeusia, and lamina propria mucosal fibrosis. The fiber elasticity is reduced, and the epithelial layer atrophies, resulting in stiffness, causing trismus, restricted opening, and eating difficulties. Physician Yang Rongwu (middle) said that long-term chewing of betel nut can easily cause oral submucosal fibrosis. The most critical rehabilitation after treatment is mouth-opening exercises, which often makes the patient's life worse than death. (Photo provided/Tainan Xinlou Hospital)

Dr. Yang Rongwu said that it is difficult to completely examine every corner of the mouth when the mouth is opened less than 2 centimeters. Among the oral cancer patients treated by the Oral and Maxillofacial Surgery Department of Xinlou Hospital, 60% are stage 3 and 4 intermediate and advanced oral cancers. After surgery, they need to cooperate with the plastic surgery department to reconstruct free flaps through microsurgery and the radiotherapy department. Radiation therapy (electrotherapy), and hematology and oncology supplemented with chemotherapy.

Although the treatment performed will definitely affect the degree of mouth opening, the General Surgery Department of Xinlou Hospital carefully treated it with a specific surgical method, that is, removing 3 closing muscles during the operation. Clinically, it was found that 95% The above patients with mid-to-late stage oral cancer can still open their mouths up to 3 centimeters 8 months after the treatment (including electrotherapy). In the future, as long as they continue to practice regular mouth opening, it is expected to maintain a mouth opening of 3 centimeters.

In addition to outpatient follow-up, the improvement of mouth opening is also an indispensable key factor in improving the quality of life such as oral hygiene care and dental treatment. Dr. Yang Rongwu emphasized that post-operative mouth opening exercises are the key to restoring mouth opening. You must use a mouth opener at least 3 times a day, 10 minutes each time, for 3 consecutive weeks. The mouth opener should be inserted deep into the mouth, close to the upper and lower rows of teeth, and the opening should be at least supported. to 4 cm, but the rehabilitation process is very painful, and up to 50% of patients cannot bear it and give up. After the golden period of rehabilitation, trying to increase the opening of the mouth has no effect.