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Acta Otolaryngol ; 133(4): 373-7, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23237095

RESUMO

CONCLUSION: It is suggested that vertigo in patients with Ramsay Hunt syndrome is mostly induced by superior vestibular neuritis consecutive to the reactivation of varicella-zoster virus (VZV) infection from the geniculate ganglion through the faciovestibular anastomosis. Refractory hearing loss in patients with Ramsay Hunt syndrome may be due to cochlear neuritis following the spread of VZV. OBJECTIVES: An attempt was made to selectively identify vestibulocochlear nerves in the internal auditory canal (IAC) on gadolinium (Gd)-enhanced MRI in patients with Ramsay Hunt syndrome. METHODS: Fourteen patients with Ramsay Hunt syndrome presenting with facial palsy, herpes zoster oticus, vertigo, and/or sensorineural hearing loss were scanned on 1.5 T MRI enhanced with Gd. Perpendicular section images of the IAC were reconstructed to identify the facial, superior, and inferior vestibular nerves and the cochlear nerves separately. RESULTS: All except one of the patients with Ramsay Hunt syndrome with vertigo showed both canal paresis on the caloric test and Gd enhancement of the superior vestibular nerve in the IAC on MRI. Among 10 patients with hearing loss, 3 patients with severe to moderate sensorineural hearing loss showed Gd enhancement of the cochlear nerve in the IAC on MRI.


Assuntos
Herpes Zoster da Orelha Externa/diagnóstico , Imageamento por Ressonância Magnética/métodos , Intensificação de Imagem Radiográfica , Neuronite Vestibular/diagnóstico , Doenças do Nervo Vestibulococlear/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Gadolínio , Perda Auditiva Neurossensorial/diagnóstico , Perda Auditiva Neurossensorial/etiologia , Herpes Zoster da Orelha Externa/complicações , Herpes Zoster da Orelha Externa/virologia , Herpesvirus Humano 3/patogenicidade , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Medição de Risco , Estudos de Amostragem , Vertigem/diagnóstico , Vertigem/etiologia , Neuronite Vestibular/etiologia , Doenças do Nervo Vestibulococlear/etiologia
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