Center for TMD and Orofacial Pain, Rutgers School of Dental Medicine, Newark, NJ, USA.
Ragas Dental College and Hospital, Chennai, India.
Curr Pain Headache Rep. 2022 Mar;26(3):219-233. doi: 10.1007/s11916-022-01018-w. Epub 2022 Feb 4.
Traumatic neuromas in general, and trigeminal traumatic neuromas in particular, are relatively rare entities originating from a damage to a corresponding nerve or its branches. This manuscript is a comprehensive review of the literature on trigeminal traumatic neuromas based on an interesting and challenging case of bilateral intraoral lesions.
The diagnosis for this patient was bilateral trigeminal traumatic neuromas. It is possible that these patients have a genetic predisposition to the development of these lesions. It is a neuropathic pain condition and may mimic dental and other trigeminal pain entities. Topical treatment with lidocaine gel, utilizing a custom-made neurosensory stent, rendered the patient significant and sustained pain relief. Trigeminal traumatic neuromas present a diagnostic challenge even to a seasoned clinician, due to the complex clinical features that may mimic other entities. Topical medications such as local anesthetics may be a good viable alternative to systemic medications to manage the pain associated with the condition. Early identification of the lesion and the associated pain helps in the succinct management of symptomatic trigeminal traumatic neuromas.
创伤性神经瘤一般较为罕见,主要源于相应神经或其分支的损伤,其中尤以三叉神经创伤性神经瘤更为特殊。本文基于一例双侧口腔内病变的有趣且具有挑战性的病例,对三叉神经创伤性神经瘤的文献进行了全面回顾。
该患者的诊断为双侧三叉神经创伤性神经瘤。这些患者可能存在发生此类病变的遗传易感性。这是一种神经病理性疼痛疾病,可能类似于牙科和其他三叉神经疼痛实体。使用定制的神经感觉支架,利多卡因凝胶的局部治疗为患者提供了显著且持续的疼痛缓解。由于可能类似于其他实体的复杂临床特征,即使是经验丰富的临床医生,三叉神经创伤性神经瘤的诊断也具有挑战性。局部麻醉等局部药物可能是管理与疾病相关疼痛的全身性药物的良好替代选择。早期识别病变和相关疼痛有助于简明管理三叉神经创伤性神经瘤的症状。