Objectives: To systematically report and document Trigeminal Trophic Syndrome (TTS), characterize its clinical presentation, diagnostic tests performed, outline management strategies, outcomes; and highlight the role of otolaryngologists in the tissue diagnosis of this rare syndrome.
Data Sources: PubMed/Medline, Scopus, and Cochrane databases.
Review Methods: PubMed/Medline, Scopus, and Cochrane databases were systematically reviewed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to identify all cases of TTS published with an English translation from inception to December 2020.
Results: A total of 142 articles describing 214 patients with TTS were included in the analysis. There was a female predominance (62.9 %) and a median age of 57 (range 1-93) years at presentation. A trigeminal neurological insult was identified in 200 (93.5 %) cases. The most common triggers for TTS were treatment for trigeminal neuralgia (35.7 %) and cerebrovascular accident (21.6 %). Self-inflicted trauma occurred in 137 (64 %) patients. Biopsy was done in 123 (57.5 %) patients. Patient education, barrier devices, and medications to address parasthesias were the most common treatment strategies. The majority of patients (72.5 %) received multimodal therapy. Surgery was performed in 35 (22.7 %) patients. Treatment outcomes were discussed in 120 (56.1 %) patients.
Conclusions: TTS is a rare condition with poorly understood pathophysiology. It should be suspected in a patient with non-healing facial ulceration and altered sensation within the trigeminal nerve distribution. Biopsy of the ulcer is important to confirm the diagnosis and exclude malignancy. Treatment options include conservative and pharmacologic measures, and less frequently surgery.
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http://dx.doi.org/10.1016/j.amjoto.2024.104354 | DOI Listing |
Actas Dermosifiliogr
November 2024
Servicio de Dermatología, Hospital Universitario San Cecilio, Granada, Spain.
Spec Care Dentist
December 2024
Department of Oral Medicine, University of Pennsylvania, School of Dental Medicine, Philadelphia, USA.
Introduction: Destruction of the trigeminal (Gasserian) ganglion or peripheral damage to the trigeminal nerve may lead to trigeminal trophic syndrome (TTS), a rare condition characterized by self-inflicted trauma. To date, under 200 cases of TTS are documented in medical literature, with only sparse studies reporting on oral complications secondary to this condition.
Case Report: The following report presents a well-documented case of oral complications associated with TTS in an 83-year-old Caucasian female presenting with right-sided lesions on her nasal ala, scalp, buccal mucosa, and tongue, secondary to self-inflicted injury following their second microvascular decompression for surgical management of trigeminal neuralgia.
WMJ
November 2024
University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
Cureus
September 2024
Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust, London, GBR.
Cornea
February 2025
John F. Hardesty Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, MO.
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