Table 1
HNC therapy complications. HNC: Head and Neck Cancer.
| Complications | |
|---|---|
| Acute | Chronic |
| Oral Mucositis | Xerostomia |
| Pain | Pain |
| Xerostomia | Trismus |
| Dysgeusia | Dysgeusia |
| Infections | Infections |
| Lichenoid reactions | Dental caries |
| Aphthous lesions | Osteoradionecrosis of the jaw Medication related necrosis of the jaw |
Table 2
Oral complications induced by Head and Neck Cancer therapies.
| RT | CT | TT | IT |
|---|---|---|---|
| Mucositis | Mucositis | Mucositis | Mucositis |
| Dysgeusia | Dysgeusia | Dysgeusia | |
| Xerostomia | Xerostomia | Xerostomia | Xerostomia |
| Infections | Infections | ||
| Dyspagia | Dyspagia | Dyspagia | |
| Aphthoid lesions | |||
| Lichenoid reactions | |||
| Pain | Pain | Pain | Pain |
| Neuropathy | Neuropathy | ||
| Trismus, fibrosis | |||
| Dental, periodontal complications | Dental, Periodontal complications | ||
| Osteoradionecrosis | Osteonecrosis related to medication | Osteonecrosis related to medication |
[i] RT: Radiotherapy, CT: Chemotherapy, TT: Targeted therapy, IT: Immunotherapy
Table 3
Definition of terms used for conditions occurring during Head and Neck Cancer therapy.
| Term | Definition |
|---|---|
| Oral Mucositis | Inflammation of oral mucosa resulting from chemotherapeutic agents or ionizing radiation, typically manifesting as erythema or ulcerations |
| Stomatitis | Refers to any inflammatory condition of oral tissue, including mucosa, periapices, and periodontium and includes infections of oral tissues as well as oral mucositis |
| Nociceptive Pain | Arises from damage to non-neural tissues due to the activation of nociceptors |
| Neuropathic Pain | Is caused by damage of the somatosensory nervous system |
| Xerostomia | Subjective feeling of oral dryness |
| Salivary gland dysfunction | Changes in quantity and/or quality of saliva |
| Salivary gland hypofunction | Decreased salivary output. |
| Hyposalivation | Decreased salivary output, due to salivary gland hypofunction. Whole saliva flow rate: unstimulated saliva ≤0.1 ml/min; stimulated saliva <0.7 ml/min |
| Dry mouth | Term used to indicate either xerostomia or salivary gland hypofunction or both |
| Dysgeusia | Taste alteration |
| Ageusia | Loss of taste |
| Hypergeusia | Heightened taste sensitivity |
| Hypogeusia | Reduced taste sensitivity |
Table 4
Diagnosis of oral mucosa's complications.
| Diagnosis | Clinical manifestation | Symptoms | Site |
|---|---|---|---|
| Mucositis | Painful ulcerations covered by removable pseudomembranes | Pain | nonkeratinized mucosa; buccal mucosa, lateral tongue, soft palate, floor of mouth |
| Candidiasis | Removable white pseudomembranes | Burning sensation, mucosal soreness, taste alterations | Dorsal side of the tongue, soft and hard palate, labial commissure |
| Herpes | Small vesicles that eventually rupture to become shallow painful ulcerations | Pain | Keratinized oral tissues, lips |
| Bacterial infections | Necrotising ulcerative gingivitis, periodontitis | Pain, bleeding | Gingiva |
| Aphthous like (aphthoid) lesions | Single or multiple, painful, well-circumscribed, round/ovoid superficial by an erythematous halo ulcers, with a gray central area, surrounded | Pain | Nonkeratinized oral tissues; buccal mucosa, soft palate, ventral and lateral side of the tongue, floor of the mouth |
| Lichenoid reactions | Whitish papules, reticular or linear, confluent in places, sometimes with erythema | Pain, soreness, or asymptomatic | Dorsal and lateral side of the tongue, lips, gingiva, hard palate, buccal mucosa |