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Neurotrophic corneal ulcer in pediatric patient with rhabdomyosarcoma of the masticator space: management and treatment

Poster Details

First Author: C.Cólliga SPAIN

Co Author(s):    F. Alcantud   L. Ibares   D. Da Saude   R. Yela   L. Marianas   B. Garcia-Valcarcel     

Abstract Details

Purpose:

Our main purpose is to describe the characteristics, evolution and treatment of neurotrophic corneal ulcers, being necessary in some cases the implantation of human amniotic membrane to treat them resulting in a clinical improvement in some resistant cases.

Setting:

Hospital Universitario Gregorio Mara�Ã�±�Ã�³n Madrid Spain

Methods:

We present a case of a recurrent neurotrophic corneal ulcer in a 8-year old boy with a rhabdomyosarcoma of the right masticator space, describing all the different treatments that we used to try to control and cure this ulcer.

Results:

8-year old patient with rhabdomyosarcoma of the masticator space, presents corneal ulcer with anesthesia in the right eye. We instaurated treatment with topical antibiotics and lubricant drops. The magnetic resonance shows invasion of the right trigeminal nerve. The patient receives radiotherapy and the ulcer gets worse, with an increase in size of the epithelial defect and a deep vascularization that reaches the ulcer. Autologous serum and latter regenerating agent (RGTA�Â�®) treatment were added, reducing the ulcer only partially, so transplantation of monolayer amniotic membrane as a coating is performed. One week later complete epithelization with remission of vascularization is observed

Conclusions:

Perineural tumour spread can occur with masticator space malignancies, especially along the trigeminal or the facial nerves, resulting in neurotrophic corneal ulcers with challenging treatment. Radiation therapy can produce a dry eye syndrome secondary to involvement of the lacrimal glands. Amniotic membrane transplantation can be an effective treatment for severe neurotrophic corneal ulcers. It suppresses the refractory inflammatory reaction, characteristic of different pathologies of the ocular surface. In this case both chemotherapy and radiotherapy have contributed to the torpid evolution of the ulcer. With the transplantation we have achieved total epithelization with a significant decrease in inflammation and corneal vascularization.

Financial Disclosure:

NONE

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