ABSTRACT
Varicella zoster virus (VZV) is the agent that causes chicken pox, a common childhood infection that characteristically presents as vesicular rashes affecting the trunk and head. After the primary infection has resolved, VZV lies dormant in the spinal dorsal root ganglia or extramedullary cranial nerve ganglia until reactivation results in herpes zoster (shingles). The sensory nerves of the trunk, as in classic shingles, and the fifth cranial nerve, as in trigeminal zoster, are the most frequently affected. Shingles is an acute viral infection characterized by the appearance of painful unilateral vesicular rash usually restricted to a dermatomal distribution of a sensory nerve. The rash of shingles is usually preceded by pain and paresthesia. A rare, severe complication of the reactivation of VZV in the geniculate ganglion of the facial nerve is Ramsay Hunt syndrome (RHS). RHS is characterized by otalgia, vesicles in the auditory canal, and ipsilateral facial paralysis. An even rarer complication of VZV infection includes post-zoster osteonecrosis. This report documents a case of severe mandibular osteonecrosis and RHS after an outbreak of herpes zoster and treatment strategies.
Subject(s)
Herpes Zoster Oticus/virology , Mandibular Diseases/virology , Osteonecrosis/virology , Antiviral Agents/therapeutic use , Debridement/methods , Follow-Up Studies , Herpes Zoster/virology , Humans , Male , Mandibular Diseases/surgery , Middle Aged , Osteonecrosis/surgery , Tomography, X-Ray Computed/methods , Tooth Exfoliation/virology , Tooth Extraction/methodsABSTRACT
PURPOSE OF REVIEW: Dentoalveolar injuries are the most common type of facial injury and are often associated with concomitant facial fractures. These injuries may initially be seen by surgeons who do not have formal dental training. This article reviews the assessment and management of dentoalveolar fractures. RECENT FINDINGS: Semi-flexible splinting of traumatized teeth for shorter periods of time than previously suggested is associated with better long-term outcomes. The use of dental implants to replace teeth lost to trauma is a predictable restorative option. SUMMARY: Surgeons need to be aware that dentoalveolar injuries may be a marker for other injuries. Prompt relocation and splinting of displaced teeth is associated with better outcomes.
