Radiation portals that include the temporomandibular joint and/or muscles of mastication may affect the capsule or muscular integrity. Radiotherapy-induced cellular damage and eventual tissue fibrosis can lead to muscle spasm, trismus, and limited function as a function of radiation dose to the area.13 These effects manifest 3 to 6 months post radiotherapy and threshold doses of anywhere from 15 Gy to 50 Gy have been reported.13
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