Trigeminotrophe Ulzeration des Nasenflügels bei Wallenberg-Syndrom

Schommer, M; Weiss, Jeffrey A.; Kiehl, Paul V.; Kapp, Alexander; Rh, Prawitz; Jp, Brodersen

doi:10.1007/s001050051148

Cited by 7 publications

(4 citation statements)

References 9 publications

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“…Of these cases, 70% were iatrogenic and occurred as a complication after surgical treatment of trigeminal neuralgia. We reviewed another 21 additional cases of TTS [1,5,4,7,12,16,17,19,21,23,28] (Table 1). Twenty-seven cases were associated with injections of alcohol into the gasserian ganglion and four cases with electrocoagulation.…”

Section: R Litschel · H Winkler · S Dazert · H Sudhoffmentioning

confidence: 99%

Herpes zoster-associated trigeminal trophic syndrome: a case report and review

Litschel

Winkler

Dazert

et al. 2003

Eur Arch Otorhinolaryngol

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The case of a 75-year-old Caucasian woman with a trigeminal trophic syndrome (TTS) is presented and discussed. TTS of the ala nasi subsequent to a herpes zoster infection has not been described previously. We provide a review of the literature with insights into the pathogenesis and current therapeutic strategies. Keywords Trigeminal trophic syndrome · Ala nasi lesion · Herpes zoster infection · ReviewCase report A 75-year-old Caucasian woman was referred to our department with a right ala nasi lesion (Fig. 1). She had a history of breast carcinoma, which had been treated with surgery and radio-chemotherapy. Three years ago, herpes zoster affected the second division of the right trigeminal nerve. Subsequently, the patient developed postherpetic neuralgia, which was treated with carbamazepine. The initial anterior rhinoscopy showed a small mucosal fissure of the right nasal ala. Treatment consisted of local application of polymyxin-B ointment. Three months later, the patient returned with a distinct lesion, which expanded within weeks and was associated with recurrent bleeding. The following physical examination revealed a crescent lesion of about 2 cm in length with a concomitant loss of a significant portion of the right ala nasi and a complete anesthesia of the maxillary dermatome. The patient complained about numbness, paresthesia and the psychosocial impact of the lesion. We ruled out a malignant lesion with biopsies, and computed tomography was performed (Fig. 2). Two biopsies from the remaining ala and the lateral nasal margin confirmed the lack of malignancy. Histopathologically, the hyperkeratotic epidermis did not have any irregularities or signs of malignant transformation. Considering the patient's history of herpes zoster in the same right maxillary dermatome and the persistence of anesthesia, we assumed a trophic malfunction, e.g., trigeminal trophic syndrome (TTS). To our knowledge, TTS of the ala nasi has not been previously reported subsequent to a herpes zoster infection. After a thorough assessment and review of the literature, we decided to Eur Arch Otorhinolaryngol (2003) 260 : 86-90

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Section: R Litschel · H Winkler · S Dazert · H Sudhoffmentioning

confidence: 99%

Herpes zoster-associated trigeminal trophic syndrome: a case report and review

Litschel

Winkler

Dazert

et al. 2003

Eur Arch Otorhinolaryngol

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“…Time of onset from injury to development of the ulcers ranged from 2 weeks to 30 years. Twenty patients (33%) had a history of stroke, half of which were Wallenberg's lateral medullary syndrome 11 (i.e., posterior inferior cerebellar artery occlusion causing ipsilateral facial numbness, contralateral extremity pain and temperature loss, ocular sympathetic palsy, vertigo, dysphagia, and dysarthria). Twenty patients (33%) had trigeminal nerve ablation with rhizotomy and/or nerve block methods for treatment of trigeminal neuralgia.…”

Section: Discussionmentioning

confidence: 99%

Trigeminal Trophic Syndrome-Report of Four Cases and Review of the Literature

Sadeghi¹,

Papay²,

Vidimos³

2004

Dermatol Surg

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“…3 ▲ Patient nach Defektdeckung mittels kontralateralem paramedianem Stirnlappen und "composite graft" aus der Ohrmuschel (11/2001) Kasuistiken tika können hilfreich sein [19,23].Vielfach wird jedoch eine Progression beobachtet, da die Patienten zum einen die Sensibilitätsstörungen und das Gefühl der nasalen Obstruktion nicht tolerieren und es sich zum anderen häufig um ältere bzw. nicht kooperative Patienten handelt, welche die teils aufwendigen Therapiemaß-nahmen nicht konsequent durchhalten [2,3,6,7,21].…”

Section: Diskussionunclassified

Das neurotrophische Ulkus des N.�trigeminus

Koch

Constantinidis

Hornung

et al. 2004

HNO

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Trigeminal trophic ulceration is a rare clinical entity after an injury to the sensitive root of the trigeminal nerve, mostly due to therapy for trigeminal neuralgia. Other rare causes are Wallenberg's syndrome or a history of removal of acoustic neuroma. After weeks to years, a slowly progressive ulceration develops due to autonomic dysfunction and the patient manipulation because of serious chronic paresthesia. Finally, in many cases, a significant defect of the nasal arch develops. In spite of typical clinical signs and location, diagnosis is made late in most cases. Reviewing the literature, two cases are presented and diagnostic problems and difficulties of the most effective therapeutic approach are discussed.

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Trigeminotrophe Ulzeration des Nasenflügels bei Wallenberg-Syndrom

Cited by 7 publications

References 9 publications

Herpes zoster-associated trigeminal trophic syndrome: a case report and review

Herpes zoster-associated trigeminal trophic syndrome: a case report and review

Trigeminal Trophic Syndrome-Report of Four Cases and Review of the Literature

Das neurotrophische Ulkus des N.�trigeminus

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