Orofacial Pain and Snoring/Obstructive Sleep Apnea in Individuals with Head and Neck Cancer: A Critical Review

J Oral Facial Pain Headache. 2022 Spring;36(2):85-102. doi: 10.11607/ofph.3176.

Abstract

Aims: (1) To summarize current knowledge on the prevalence, intensity, and descriptors of orofacial pain and snoring/obstructive sleep apnea (OSA) before and after head and neck cancer (HNC) treatment; and (2) to propose future directions for research.

Methods: The median prevalence for each condition was estimated from the most recent systematic reviews (SRs) and updated with new findings retrieved from the PubMed, Web of Science, Embase, and Cochrane databases up to December 2021.

Results: The prevalence of HNC pain seems relatively stable over time, with a median of 31% before treatment in three studies to a median of 39% at 1 month to 16 years after treatment in six studies. HNC pain intensity remains mild to moderate. There was a threefold increase in temporomandibular pain prevalence after surgery (median 7.25% before to 21.3% after). The data for snoring prevalence are unreliable. The OSA/HNC prevalence seems relatively stable over time, with a median of 72% before treatment in three studies to 77% after treatment in 14 studies.

Conclusion: With the exception of temporomandibular pain, the prevalence of HNC pain and OSA seems to be stable over time. Future studies should: (1) compare the trajectory of change over time according to each treatment; (2) compare individuals with HNC to healthy subjects; (3) use a standardized and comparable method of data collection; and (4) assess tolerance to oral or breathing devices, since HNC individuals may have mucosal sensitivity or pain.

Publication types

  • Review

MeSH terms

  • Facial Pain / epidemiology
  • Facial Pain / etiology
  • Head and Neck Neoplasms* / complications
  • Humans
  • Prevalence
  • Sleep Apnea, Obstructive* / epidemiology
  • Sleep Apnea, Obstructive* / therapy
  • Snoring / epidemiology
  • Snoring / therapy

Grants and funding

The Canada Research Chair of GL and R Denis Foundation. The Surgery Department, Montreal Sacré Coeur Hospital, contributed to the financial support of this review. The authors thank Paul Davis, São Paulo, Brazil, and Joshua Wolfe, Montreal, Canada, for English revisions and useful comments on text clarity.