Periocular manifestations of trigeminal trophic syndrome: A case series and literature review

McVeigh, Katherine; Adams, M K M; Harrad, R A; Ford, Rebecca

doi:10.1080/01676830.2017.1353117

Cited by 13 publications

(20 citation statements)

References 9 publications

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“…Ophthalmological examination further revealed the under‐recognized right‐eye corneal erosion (c, arrows). The patient received gabapentin treatment and occlusive dressing to preserve vision …”

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confidence: 99%

Image Gallery: Trigeminal trophic syndrome: nonhealing facial ulcer with corneal ulceration

Liu

Chang

2019

Br J Dermatol

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DEAR EDITOR, A 56-year-old woman presented with a large nonhealing ulcer on the right face for 6 months (a). She had received systemic antibiotics for suspected facial cellulitis. Neurological examination revealed diminished sensation to touch, pinprick and temperature affecting the right first, second and third divisions of cranial nerve V. Radioimaging showed an infarction at the right posterior medulla oblongata (b, arrow). The crescentic ulceration involving the ala nasi was self-induced secondarily to trigeminal paraesthesia. Ophthalmological examination further revealed the under-recognized right-eye corneal erosion (c, arrows). The patient received gabapentin treatment and occlusive dressing to preserve vision. 1,2

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confidence: 99%

Image Gallery: Trigeminal trophic syndrome: nonhealing facial ulcer with corneal ulceration

Liu

Chang

2019

Br J Dermatol

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“…10 The perceived sensation of cutaneous irritation prompts patients to rub, pick, or scratch the affected area. 2,12 Manipulation of the skin in TTS appears to be a reflexive action to alleviate dysesthesias and should be differentiated from dermatitis artefacta in which the self-inflicted trauma is a manifestation of psychiatric disturbance. 10 The patient described in this report did not present with the characteristic triad of symptoms.…”

Section: Discussionmentioning

confidence: 99%

Trigeminal Trophic Syndrome—A Unique Clinical Presentation of a Rare Condition

et al. 2019

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This study describes a unique clinical presentation of trigeminal trophic syndrome (TTS), which is not well described within the otolaryngology literature. Trigeminal trophic syndrome classically presents with a triad of symptoms: trigeminal anesthesia, facial paresthesias, and crescent-shaped ulceration of the lateral nasal ala. The patient discussed in this report had a self-induced, waxing and waning ulceration of the frontal scalp for 7 years and was evaluated and treated ineffectively by multiple physicians, including otolaryngologists, before TTS was diagnosed and a targeted treatment was initiated. Although extranasal presentation is uncommon, this condition must be considered when ulcers are encountered in the trigeminal dermatome. This case highlights the variability in presentation and the importance of awareness of this rare syndrome. We aim to facilitate more prompt diagnosis and expedite the initiation of appropriate treatment for TTS in the field of otolaryngology.

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“…Another theory suggests that the ulceration is caused traumatically secondary to paresthesia by an unconscious self-manipulation. Self-induced trauma because of neurologic injuries and facial paresthesia causes ulceration that is difficult to heal (16) .…”

Section: Discussionmentioning

confidence: 99%

Nasal alar deformity: a very rare complication of acoustic neuroma surgery after ipsilateral trigeminal and facial nerve paralysis

Ieridou¹,

Printza²,

Tsinaslanidou³

et al. 2018

RHINOL

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Background: Nasal alar deformity (NAD) can affect both nasal breathing and the aesthetic appearance of the nose. NAD can be congenital or acquired. The acquired causes include nerve palsies, traumatic or iatrogenic. A rare condition that is associated with NAD is trigeminal trophic syndrome (TTS). TTS is an uncommon disorder of the trigeminal nerve characterized by a triad of facial ulcers, with anesthesia and paresthesia of the involved dermatomes. Nasal alar reconstruction is challenging for the surgeon and when it is performed, a delicate balance between aesthetic and functional outcome should be considered. Case report: A 37 years old woman presented with nasal alar deformity caused by facial and trigeminal nerve paralysis after brain surgery. The woman was diagnosed with an acoustic neuroma and underwent complete tumor removal from neurosurgeons. After surgery, the patient suffered from facial and trigeminal nerve paralysis and 4-years later she presented with a progressive nasal alar deformity accompanied by breathing and aesthetic dysfunction. Reconstruction of the nasal ala was performed in one-stage surgery using spreader, alar batten and rim grafts. Seven years postoperatively, our patient had good nasal breathing and did not show any alar collapse. Conclusions: In our case we believe that facial and trigeminal nerve palsies as a result of brain surgery, have both contributed to the deformity of the nasal ala. Reconstruction with the optimal technique and graft guaranteed long term results.

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Periocular manifestations of trigeminal trophic syndrome: A case series and literature review

Cited by 13 publications

References 9 publications

Image Gallery: Trigeminal trophic syndrome: nonhealing facial ulcer with corneal ulceration

Image Gallery: Trigeminal trophic syndrome: nonhealing facial ulcer with corneal ulceration

Trigeminal Trophic Syndrome—A Unique Clinical Presentation of a Rare Condition

Nasal alar deformity: a very rare complication of acoustic neuroma surgery after ipsilateral trigeminal and facial nerve paralysis

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