我国南方鼻咽癌高发，2014年我院收治鼻咽癌患者1243例。放射治疗技术的进步明显减少了颞颌关节及其周围肌肉群的放射损伤和放疗后张口困难等后遗症，我们的前期研究却发现仍有5.7%的接受调强放疗的鼻咽癌患者发生张口困难。张口困难一旦发生，没有有效的治疗手段可以缓解。因而，如何在治疗前或治疗中筛选出这部分高危患者，并在制定放疗计划时予以特别关注和个体化处理格外重要。本项目实验研究基于SARRP小动物精确辐照仪平台，利用新西兰兔构建放疗后颞颌关节损伤模型，临床研究检测鼻咽癌患者放疗前中后颞颌关节滑液相关因子和血清学纤维化特异指标的动态变化，并监测放疗后颞颌关节和周围肌群损伤的磁共振影像动态变化，建立基于关节滑液学、血清学和影像学参数预测张口困难发生概率的评分系统，为颞颌关节及其肌肉群放射损伤的预测和早期诊断提供实验室指标和临床依据。

Nasopharyngeal carcinoma (NPC) is common in southern China. 1243 new NPC patients were treated in our hospital in 2014. The progress of Radiation technology improves outcomes of radiotherapy, and decrease normal tissues complication. Intensity modulated radiation therapy (IMRT) provides better temporomandibular joint (TMJ) sparing. However, there are still about 6% patients developed radiation-induced trismus after IMRT. Nowadays, it is important to screen patients who is apt to trismus and detect it as early as possible because there is no effective treatment for trismus once it occurs. Experimental study of this project aims to establish a stable radiation-induced trismus model, by using New Zealand rabbits based on small animal radiation research platform (SARRP). Clinical study of this project aims to establish a score model,by investigating the relationship between certain types of cytokines and growth factors in serum and synovia and radiation-induced trismus, and exploring the distinctive magnetic resonance imaging of the anatomical morphology of radiation-induced trismus after IMRT. The result of our study provides new laboratorial and clinic methods for early detecting radiation-induced trismus.