Arasi R, McKay M, Grist W J
Department of Dermatology, Emory University School of Medicine, Atlanta, GA.
Laryngoscope. 1988 Dec;98(12):1330-3. doi: 10.1288/00005537-198812000-00009.
Trigeminal trophic syndrome is an unusual condition also known as trigeminal neurotrophic ulceration or trigeminal neuropathy with nasal ulceration. The diagnosis is suggested when ulceration of the face, especially of the ala nasi, occurs in a dermatome of the trigeminal nerve that has been rendered anesthetic by a surgical or other process involving the trigeminal nerve or its central sensory connections. A history of paresthesias and self-induced trauma to the area further support the diagnosis. Neurological deficits causing trigeminal trophic syndrome may result from surgical trigeminal ablation, vascular disorders and infarction of the brainstem, acoustic neuroma, postencephalitic parkinsonism, and syringobulbia. The following etiologies of nasal ulceration should be excluded: postsurgical herpetic reactivation and ulceration, syphilis, leishmaniasis, leprous trigeminal neuritis, yaws, blastomycosis, paracoccidioidomycosis, lethal midline granuloma, pyoderma gangrenosum, Wegener's granulomatosis, and basal cell carcinoma. In the case reported here, the diagnosis of TTS was made primarily as a result of previous experience with the syndrome, underscoring the importance of physician recognition of this unusual disorder.
三叉神经营养综合征是一种罕见病症，也被称为三叉神经神经营养性溃疡或伴有鼻溃疡的三叉神经病变。当面部尤其是鼻翼出现溃疡，且溃疡发生在因涉及三叉神经或其中枢感觉连接的手术或其他过程而导致麻醉的三叉神经皮节时，应考虑该诊断。该区域的感觉异常病史和自我诱发的创伤进一步支持诊断。导致三叉神经营养综合征的神经功能缺损可能源于三叉神经外科手术切除、血管疾病和脑干梗死、听神经瘤、脑炎后帕金森综合征以及延髓空洞症。应排除以下鼻溃疡病因：术后疱疹病毒再激活和溃疡、梅毒、利什曼病、麻风性三叉神经炎、雅司病、芽生菌病、副球孢子菌病、致死性中线肉芽肿、坏疽性脓皮病、韦格纳肉芽肿以及基底细胞癌。在本文报道的病例中，三叉神经营养综合征的诊断主要基于对该综合征的既往经验积累，这凸显了医生认识这种罕见病症的重要性。
