Triangle of death (Latin: triangulum mortis) - this term is not a popular term, despite the fact that the triangle of death can be found on every person's face. Activities within it, including Squeezing pimples may have serious he alth consequences, such as meningitis or cavernous sinus thrombosis. Where is the triangle of death and why can it lead to life-threatening diseases?

The death triangle(Latintriangulum mortis ), unlike the Bermuda Triangle, is an obscure term. However, it is worth being aware of its existence, because each of us has it, and in unfavorable circumstances, it can cause serious he alth problems.

The triangle of death: what is it?

The death triangle is defined as the area of ​​the face with specific venous vascularization. The basis of this structure is a line extending between both corners of the mouth, and its apex marks the apex of the nose pyramid. Thus, the upper lip and the greater part of the nose are located within the triangle of death. The first description of the triangle of death is quite long ago, dating back to 1852. While the concept is by no means a new term, few people know about the existence of the death triangle. This is bad, because - although these are rare phenomena nowadays, in the age of wide availability of antibiotics - the threat posed by the existence of the death triangle is quite serious.

The death triangle: what are the risks?

Doctors often advise patients not to remove any skin lesions - e.g. purulent pimples or boils located on the face - by themselves. Squeezing out a negative pimple may seem tempting, but it carries a serious he alth risk.

We are talking here primarily about the risk of infection of such a lesion - squeezing pimples favors the penetration of bacteria into tissues with interrupted continuity. Incredible as it may seem, this seemingly minor skin infection can result in life-threatening diseases that develop inside the skull, such as meningitis and brain abscesses.

The veins that carry blood away from the areathe triangle of death - incl. the facial vein, the superior and inferior ocular vein or the angular vein - they eventually reach the cavernous sinus inside the skull. It is through these vessels that the infection (initially within the skin) can spread and lead to the above-mentioned complications, but also to cavernous sinus thrombosis. Such complications may be caused by the fact that in some people these vessels do not have valves, so any infections can spread to the inside of the skull much faster.

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The triangle of death and cavernous sinus thrombosis

Cavernous sinus thrombosis deserves to be discussed when describing the death triangle because the course of this disease and the symptoms associated with it are quite serious. The development of this disease can be quite rapid - it can take as little as two or sometimes even a day. Patients with cavernous sinus thrombosis develop local facial symptoms as well as various general symptoms. The first ones include:

  • protrusion of the eyeballs with their immobilization,
  • visual disturbance (caused by pressure on the optic junction),
  • dilated pupils with the accompanying lack of their response to light,
  • photophobia,
  • swelling around the eyeballs,
  • face hypersensitivity.

These types of disorders are associated with the occurrence of cranial nerve paralysis in the course of thrombophlebitis of the cavernous sinus. In the area of ​​the cavernous sinus, there are many cranial nerves, such as the oculomotor (III), block (IV) and abduction (VI) nerves, as well as two of the three main branches of the trigeminal (V) nerve, i.e. the optic (V1) and maxillary nerves. (V2). Damage to these nerves, appearing in the course of cavernous sinus thrombosis, leads to the above-mentioned symptoms (for example, disturbances in the mobility of the eyeballs result from paralysis of the oculomotor muscles innervated by cranial nerves III, IV and VI damaged during the disease).

Patients with cavernous sinus thrombosis also experience general symptoms, which include:

  • nausea,
  • vomiting,
  • headache,
  • characteristic fever (in the course of which there are significant fluctuations in body temperature - periods of increased heat are alternated with periods with normal temperature),
  • chills,
  • disturbance of consciousness.

Cavernous sinus thrombosis: treatment

It is clear that cavernous sinus thrombosis is not a trivial entity. Its treatment mainly involves antibiotics (which are usually administered intravenously), as well as drugs from other groups, such as, for example, anticoagulants or glucocorticosteroids. Occasionally, it may also be necessary to undergo surgical treatment, but surgical debridement of the cavernous sinus is performed only in patients with the most severe course of cavernous sinus thrombosis.

Analyzing the above, it is probably perfectly clear that the death triangle simply lives up to its name. Therefore, it is worth taking the advice of doctors seriously and not disturbing any skin changes. It is true that the incidence of complications of squeezing skin lesions in the form of cavernous sinus thrombosis is so rare that even studies on the frequency of such a problem are not available, however … it is better to prevent than to cure, and that is why it is best to leave it alone or possibly go to the doctor with them.

About the authorBow. Tomasz NęckiA graduate of medicine at the Medical University of Poznań. An admirer of the Polish sea (most willingly strolling along its shores with headphones in his ears), cats and books. In working with patients, he focuses on always listening to them and spending as much time as they need.

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