Evidence map›Paper›PMID 42287349›Full record

ReviewInsights into imaging2026

Imaging findings in the temporomandibular joint complex following radiation therapy for head and neck cancer: a review.

Andrew Nalley, Madeline Yon, Kuo Feng Hung, Andy Wai Kan Yeung, Gang Li, Yiu Yan Leung, Tiffany Y So, Ho Sang Leung, Qi Yong H Ai

Abstract readReview
In one paragraph

Review in Insights into imaging, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Andrew NalleyOral and Maxillofacial Radiology, Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China. analley@hku.hk.ORCID http://orcid.org/0000-0001-7594-1276
Madeline YonCentre for Oral Clinical Research, Institute of Dentistry, Queen Mary University of London, London, United Kingdom.
Kuo Feng HungOral and Maxillofacial Radiology, Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China.
Andy Wai Kan YeungOral and Maxillofacial Radiology, Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China.
Gang LiDepartment of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology, Beijing, China.
Yiu Yan LeungDivision of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China.
Tiffany Y SoDepartment of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China.
Ho Sang LeungDepartment of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China.
Qi Yong H AiDepartment of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China. hemisai@cuhk.edu.hk.

Funding

University Research Committee, University of Hong Kong 109900036
6 · The paper itself

Abstract

objectivesThis study aimed to identify and synthesize imaging findings in the temporomandibular joint (TMJ) complex following radiation therapy (RT) for head and neck cancer (HNC). MATERIALS AND

methodsA systematic search of five databases retrieved studies reporting post-RT imaging of TMJ structures. Extracted data included patient demographics, RT dose and technique, imaging modality, imaging changes and clinical findings. Risk of bias was assessed using ROBINS-I V2 (Risk of bias in non-randomized studies-of interventions, version 2).

resultsEleven retrospective studies (282 patients; mean age 52.7 years; RT dose 30-110 Gy) were included. Post-RT analysis was evaluated by imaging modalities of MRI (7 studies), CT (4), US (1), and panoramic images (1). The most commonly described structural changes in the muscles of mastication included MRI signal abnormalities (43 patients), atrophy (20 patients) and hypertrophy (20 patients), while condylar changes included erosion (11 patients), surface irregularity (12 patients) or sclerosis (6 patients). Trismus was identified in 126 patients (44.7%). No study described changes to the glenoid fossa or articular eminence or direct osteoradionecrosis (ORN) of TMJ structures. All studies exhibited moderate to critical risk of bias, limiting the certainty of associations.

conclusionsRT can induce structural changes across TMJ components detectable on imaging, which may contribute to trismus and functional impairment. Current evidence is limited, heterogeneous and retrospective, underscoring the need for prospective studies with standardized imaging and clinical correlation. KEY POINTS: Radiation therapy for head and neck cancer can affect jaw structures. Imaging shows changes in muscles and joints that are involved with chewing and mouth opening. These changes may lead to trismus (difficulty opening the mouth). Nearly half of patients in reviewed studies experienced this condition, impacting daily life. Current evidence is limited and inconsistent. Prospective studies with standardized imaging approaches are needed to further clarify radiation-related TMJ changes.

Indexed as

Head and neck cancerRadiologyRadiotherapyTMJTrismus

Identifiers

PMID42287349
PMCPMC13264650

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.