Trigeminal trophic syndrome: A report of two cases and review

Abstract

[Editorial Comment: Trigeminal trophic syndrome is a rare condition occurring in patients with trigeminal anesthesia. The most common cause is trigeminal rhizotomy for neuralgia. The absence of protective sensory feedback allows trauma to proceed to severe ulceration without pain. It is important that the otolaryngologist be aware of this rare syndrome.) Trigeminal trophic syndrome (TTS),‘-’ trigeminal neuropathy with nasal ulceration,8~g trigeminal neurotrophic ulceration,“*l’ trophic ulceration of the ala nasi,l’ and ulceration in arc13 are terms that describe a distinctive facial ulceration following sensory impairment of the trigeminal nerve. This uncommon clinical entity was first described by Loveman in 1933,14 and independently by McKenzie15 2 months later. Since then, numerous investigators have described similar cases of nasal erosion or chronic facial ulceration following sensory impairment in the trigeminal area. In 1982 Weintraub reviewed 63 cases of TTS and found that 46% occurred after trigeminal rhizotomy and 29% after alcohol injection of the gasserian ganglion. Less frequent causes included vertebrobasilar insufficiency (9%), acoustic neuroma (5%), postencephalitic parkinsonism (5%), syringobulbia (2%), and unknown (5%).’ Two women who demonstrated this lesion are described.