phenylephrine-hydrochloride and Trigeminal-Neuralgia

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.

Topics: Aged; Female; Follow-Up Studies; Herpes Zoster; Humans; Nose; Skin Ulcer; Surgical Flaps; Syndrome; Tomography, X-Ray Computed; Treatment Outcome; Trigeminal Neuralgia; Wound Healing

Surgical access to the second (V2, maxillary) and third (V3, mandibular) branches of the trigeminal nerve (V) has been classically through a transoral approach. Increasing expertise with endoscopic anatomy has achieved less invasive, more efficient access to skull base structures. The authors present a surgical technique using an endoscopic endonasal approach for the treatment of painful V2 neuropathy.. Endoscopic endonasal dissections using a transmaxillary approach were performed in four formalin-fixed cadaver heads to expose the V2 branch of the trigeminal nerve. Relevant surgical anatomy was evaluated and anatomic parameters for neurectomy were identified.. Endoscopic endonasal transmaxillary approaches completed bilaterally to the pterygopalatine and pterygomaxillary fossae exposed the V2 branch where it emerged from the foramen rotundum. The anatomy defined for the location of neurectomy was determined to be the point where V2 emerged from the foramen rotundum into the pterygopalatine fossa. The technique was then performed in 3 patients with intractable painful V2 neuropathy.. In our cadaveric study and clinical cases, the endoscopic endonasal approach to the pterygopalatine fossa achieved effective exposure and treatment of isolated V2 painful neuropathy. Important surgical steps to visualize the maxillary nerve and its branches and key landmarks of the pterygopalatine fossa are discussed. This minimally invasive approach appears to be a valid alternative for select patients with painful V2 trigeminal neuropathy.

Topics: Adult; Cadaver; Humans; Maxillary Nerve; Natural Orifice Endoscopic Surgery; Nose; Pain; Peripheral Nervous System Diseases; Pterygopalatine Fossa; Sphenoid Bone; Trigeminal Nerve; Trigeminal Neuralgia

Trigeminal trophic syndrome (TTS) is an uncommon medical condition that may be encountered by otolaryngologists and facial plastic surgeons. TTS begins with damage to the trigeminal nerve or its central sensory connections, causing anesthesia in a dermatomal distribution. With repeated scratching and manipulation, an ulceration occurs, often in the alar region. In this multi-institutional report, we summarize a small series of patients with TTS. Treatment options are discussed along with a review of the relevant literature. Although rare, it is important that practicing otolaryngologists be familiar with the classic signs and symptoms of this condition in order to avoid delays in diagnosis and treatment.

Topics: Adult; Female; Follow-Up Studies; Humans; Hypesthesia; Male; Middle Aged; Nose; Nose Diseases; Postoperative Complications; Reoperation; Rhinoplasty; Skin Ulcer; Surgical Flaps; Trigeminal Nerve; Trigeminal Nerve Diseases; Trigeminal Neuralgia

To explore the feasibility of endoscopic surgery for primary trigeminal neuralgia, and to evaluate its advantages and disadvantages.. Fifteen patients diagnosed as primary trigeminal neuralgia were included in this study. All of them had maxillary neuralgia, concurrently with 8 ophthalmic neuralgia and 2 mandibular neuralgia. The median course of disease was 4 years. The surgeries were performed by transnasal endoscope, through sphenopalatine foramen, into the pterygopalatine fossa, to find rotundum foramen, and then coagulated and cut the maxillary nerve. Post-operative evaluation was done based on Brisman R' s way. The post-operative improvement of symptom was compared with preoperative symptom, and the complications of this operation were observed.. The follow-up time was 6 months to 16 months, with the median time of 13 months. Thirteen patients were cured, 2 patients had effective outcome. Seven months after operation, 1 patient appeared supraorbital neuralgia. After the radiofrequency operation, the pain was improved. All of the patients had no serious complications and no subjective discomfort of nose and eyes.. The surgery for primary maxillary neuralgia under transnasal endoscope had a direct way to rotundum foramen, with clear operative vision. It is a minimally invasive surgery, it can minimize the serious complications. The primary curative effect is confirmed.

Topics: Adult; Aged; Endoscopy; Female; Humans; Male; Maxilla; Middle Aged; Nose; Trigeminal Neuralgia

Topics: Aged, 80 and over; Alcohols; Female; Humans; Nose; Plastic Surgery Procedures; Recurrence; Surgical Flaps; Trigeminal Ganglion; Trigeminal Neuralgia; Ulcer

Treatment of trigeminal trophic syndrome is challenging and often unsatisfactory, particularly in patients with cognitive impairment. We report the novel use of a thermoplastic dressing in two patients with trigeminal trophic syndrome. Use of the dressing resulted in successful healing of ulceration in both patients, which has been maintained in the short term, representing a simple and economical therapeutic option in the management of this difficult condition.

Topics: Aged, 80 and over; Bandages; Female; Humans; Hypesthesia; Male; Middle Aged; Neurosurgical Procedures; Nose; Postoperative Complications; Skin Ulcer; Syndrome; Trigeminal Nerve Injuries; Trigeminal Neuralgia; Wound Healing

Topics: Aged; Ethanol; Facial Pain; Female; Follow-Up Studies; Glycerol; Humans; Injections; Necrosis; Nose; Trigeminal Ganglion; Trigeminal Neuralgia

Three Japanese patients with trigeminal trophic syndrome, a rare dermatosis in Japan, were reported. Cutaneous lesions were a long-standing ulcer and destruction of the right ala nasi in case 1, a persistent deep ulceration on the forehead after a small trauma in case 2, and development of small, discrete ulcers on the right forehead during the treatment of a postherpetic neuralgia in case 3. A protective device was very effective in one patient.

Topics: Aged; Diabetes Complications; Facial Dermatoses; Female; Herpes Zoster; Humans; Male; Middle Aged; Nose; Syndrome; Trigeminal Neuralgia; Ulcer

Nasociliary neuralgia has not to our knowledge been linked with inflammatory cutaneous lesions. We observed the phenomenon and postulate that it may be frequent but overlooked.

Topics: Acne Vulgaris; Adult; Humans; Male; Nose; Trigeminal Neuralgia

A severe injury by fluid Ammonia of the nasal mucosa resulted with a strong irritation of the 1. and 2. branch of the trigeminus nerve with sudden and heavy attacks of pain. The region below the head of the right inferior nasal concha was detected as a trigger zone for smoke, smell, dust and cold air. Local anaesthesia stopped the attacks. The surgical excision and electrocoagulation of that aerea and the lateropexis of the inferior concha avoided the returning of the troubles for over a half year. The recommencement of the attacks could be stopped by local application of carbolic acid solution (10%). A similar treatment could not be found in the literature.

Topics: Adult; Ammonia; Burns, Chemical; Electrocoagulation; Female; Humans; Nose; Trigeminal Nerve Injuries; Trigeminal Neuralgia

Topics: Face; Female; Humans; Nose; Skin Ulcer; Trigeminal Neuralgia

Topics: Age Factors; Aged; Ear; Ear Canal; Ear, External; Ear, Middle; Face; Humans; Larynx; Lymph Node Excision; Nasopharyngeal Neoplasms; Nasopharynx; Neck Dissection; Nose; Otitis Externa; Otorhinolaryngologic Diseases; Paranasal Sinus Neoplasms; Paranasal Sinuses; Parotid Gland; Pharynx; Rehabilitation; Submandibular Gland; Thyroid Gland; Tonsillectomy; Tracheotomy; Trigeminal Neuralgia; Tuberculosis, Lymph Node; Zygoma

Topics: Aged; Denervation; Dermatitis; Dysautonomia, Familial; Female; Humans; Nose; Nose Diseases; Postoperative Complications; Surgery, Plastic; Trigeminal Neuralgia

Topics: Carcinoma, Basal Cell; Diagnosis, Differential; Geriatrics; Humans; Neurosurgery; Neurosurgical Procedures; Nose; Postoperative Complications; Skin Ulcer; Trigeminal Nerve; Trigeminal Neuralgia

Topics: Facial Injuries; Humans; Lidocaine; Neuralgia; Nose; Ophthalmic Nerve; Trigeminal Neuralgia

Topics: Humans; Hypoxia; Nose; Nose Diseases; Olfactory Nerve; Otolaryngology; Pain; Paranasal Sinuses; Sensory Receptor Cells; Trigeminal Neuralgia

Topics: Alopecia Areata; Dermatology; Humans; Keratitis; Neurosurgery; Neurosurgical Procedures; Nose; Nose Deformities, Acquired; Postoperative Complications; Trigeminal Nerve; Trigeminal Neuralgia

Topics: Cheek; Disease; Face; Humans; Necrosis; Nose; Nose Diseases; Plastics; Surgery, Plastic; Trigeminal Neuralgia

Topics: Humans; Nose; Peripheral Nervous System Diseases; Skin Diseases; Trigeminal Neuralgia; Ulcer