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SUSAN AGHAJANZADEH
Dissertation defense: 16 May  2025 (click for details)
Doctoral thesis: 
Research area: Otorhinolaryngology
Sahlgrenska Academy, The Institute of Clinical 91̽��s

Every year, about 1,700 people in Sweden are diagnosed with head and neck cancer (HNC). Cancer in this area can lead to significant pain and make it difficult to eat and talk. The symptoms may result from the disease itself, or as side effects from treatment.

Nearly three out of four HNC patients receive radiation therapy, although surgery and medical cancer treatments are also commonly used in different combinations. Unfortunately, radiation can lead to a wide range of complications—one common complication is reduced ability to open one’s mouth, a condition known as trismus. *

“We’ve investigated how common certain side effects are after radiotherapy for head and neck cancer, and how they affect health-related quality of life. A key part of our research was to examine the long-term wellbeing of affected patients,” says Susan Aghajanzadeh, senior otolaryngologist at Högsbo Hospital and a doctoral student at the Institute of Clinical 91̽��s.

She has also explored the coping strategies that patients develop to manage their symptoms, how they perceive the care they’ve received, and what they wish for from the healthcare system. Three of the studies were based on measurements of mouth opening ability and survey data collected repeatedly over five years. One study was based on interviews.

Restricted mouth opening and pain linked to lower quality of life

“We found that problems with mouth opening ability were common after radiotherapy. One year after treatment, 28% of the 211 patients in the study reported difficulty opening their mouths. At the five-year follow-up, 27% were still experiencing these issues.”

Facial pain was also common—both before and after radiation. Half of the patients reported pain before treatment began. At the three-month follow-up, that number climbed to 70%, and five years later, 41% still experienced pain. Both limited mouth opening ability and facial pain were closely linked to reduced quality of life.

Multidisciplinary rehab teams and personalized care needed

Early and structured jaw exercises have previously proven effective in managing trismus and related facial pain and are recommended as a way to improve mouth opening ability—and, in turn, health-related quality of life.

“Patients also developed their own ways of coping and were generally satisfied with their care. Still, many wanted better long-term follow-up and easier access to support groups. These results highlight the need for multidisciplinary rehab teams and more personalized care for this group of patients.”

What has been the most rewarding and challenging part of your PhD project?

“It’s been deeply meaningful to contribute new knowledge about the long-term effects of restricted mouth opening and facial pain. Meeting and interviewing patients has given me a deeper understanding of their experiences and coping strategies. At the same time, it’s been challenging to navigate the large amount of data and decide what’s most relevant. The next big challenge is to translate our findings into clinical practice.”

Text: Susanne Lj Westergren