[Treatment of neurotrophic ulceration following alcohol injection of the gasserian ganglion in trigeminal neuralgia: Case report and review of the literature].

Autor: Hufschmidt K; Service de chirurgie réparatrice et plastique, CHU Pasteur 2, 30, avenue de la Voie-Romaine, 06200 Nice, France. Electronic address: katharinahufschmidt@gmail.com., Fernandez J; Service de chirurgie réparatrice et plastique, CHU Pasteur 2, 30, avenue de la Voie-Romaine, 06200 Nice, France., Balaguer T; Service de chirurgie réparatrice et plastique, CHU Pasteur 2, 30, avenue de la Voie-Romaine, 06200 Nice, France., Fontaine D; Service de neurochirurgie, CHU Pasteur 2, 30, avenue de la Voie-Romaine, 06200 Nice, France., Chignon-Sicard B; Service de chirurgie réparatrice et plastique, CHU Pasteur 2, 30, avenue de la Voie-Romaine, 06200 Nice, France.
Jazyk: francouzština
Zdroj: Annales de chirurgie plastique et esthetique [Ann Chir Plast Esthet] 2017 Feb; Vol. 62 (1), pp. 79-86. Date of Electronic Publication: 2016 Apr 20.
DOI: 10.1016/j.anplas.2016.03.004
Abstrakt: Introduction: Trigeminal trophic syndrome (TTS) can occur after any injury on the fifth cranial nerve. The etiology is dominated by iatrogenic causes, especially after gasserian ganglion ablation. Middle-aged women are mostly involved and the differential diagnosis is vast.
Presentation of Case: A 88-year old woman presented with TTS and destruction of the right nasal ala 25 years after retrogasserian alcohol injection for trigeminal neuralgia. Facing iterative failure of medical treatment, topics and neurostimulation, we performed lipofilling for the lesion. In the third month, we found a 50 % decrease in size of the lesion, as well as a complete disappearance of pruritus, thus allowing to consider reconstructive surgery.
Discussion: Our literature review reports 28 cases of TTS subsequent to alcohol injection of the gasserian ganglion. Age of presentation ranges from 49 to 88 years, with a time of onset between trigeminal injury and TTS ranging from 2 weeks to 17 years. Recurrences are frequent. The management varies a lot according to the authors (topics, antibiotics, flaps), however the efficiency of lipofilling has not been reported yet.
Conclusion: The pathophysiology of TTS remains unknown, nevertheless the therapeutical care has to be multidisciplinary. Even though not described yet, lipofilling seems to be an interesting treatment of TTS following alcohol injection in the trigeminal ganglion.
(Copyright © 2016 Elsevier Masson SAS. All rights reserved.)
Databáze: MEDLINE
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