Treatment of Trigeminal Trophic Syndrome using Scalp Based Flap Reconstruction: Case Report

Abstract

Trigeminal trophic syndrome, or trigeminal neurotrophic ulceration, is an uncommon cause of persistent or recurrent facial ulceration, paresthesia, and anesthesia following self-manipulation of the skin, most commonly affecting the maxillary branch of the trigeminal nerve in the ala nasi region. We present a case of a 63-year-old with chronic ulceration of the right frontoparietal scalp involving the ophthalmic branch of the trigeminal nerve following herpes zoster infection. The patient was successfully treated with a fasciocutaneous transposition flap and splitthickness skin graft; these procedures allowed us to avoid the diseased ophthalmic nerve distribution. This patient’s postoperative course was uneventful, and the flap and skin graft healed without further ulceration of the involved area at 1 year follow-up.