Piercings, phories verticales et contrôle postural : rapport de cas

Piercings, which are on the increase, can induce various infectious, allergic, cutaneous or dental complications. Vertical heterophoria (VH) and orthophoria correspond, respectively, to the presence or absence of a vertical deviation between the two eyes when the retinal images are dissociated. The present case report concerns vertical phorias and postural control of young adults with facial piercings and presenting with differing chronic functional pain. Following pain assessment (VAS), the VH systematically found were detected and measured using the Maddox test. Postural performance was assessed on a force platform: with eyes open (EO), EO with a prism cancelling the VH, and eyes closed; and without the piercings eyes open and closed. A control was made several days later. The VH are cancelled when the piercings are removed. The cancellation of the VH with a prism reinforces postural stability; this result is also obtained when the piercings are removed. The control at distance leads to the same observation with a fair reduction in pain. Piercings could therefore have induced more complications than those described in the literature This case report, obviously requiring further studies, confirms earlier suggestions: VH could indicate disrupted somesthetic information (in our case: piercings in the trigeminal area) feeding the sensorial motor loops implied in postural control. The persistence of such conflicts could well lead to pain and modify perception.