RESUMO
OBJECTIVES: The aim of this study was to define the typical pattern for varicella zoster virus (VZV) reactivation in delayed facial palsy (DFP) after stapedectomy for otosclerosis. MATERIALS AND METHODS: Review of the relevant literature, personal casistics, and case-report. RESULTS: In total, 48 cases of DFP after stapes surgery have been described so far, including the reported case with exclusive manifestation of atypical Ramsay Hunt syndrome (RH); in the personal series of 1253 stapedectomies, DFP occurred in only one case (0.08%). Complete DFP (House-Brackmann grade VI) rapidly developed 12 days after surgery; RH appeared 2 days later, confirming the role of VZV. The DFP started improving after 8 weeks and completely recovered 6 months later. CONCLUSION: Acute otalgia prior to DFP should raise the suspicion of VZV reactivation. Atypical RH is the most frequent pattern that occurs in DFP after stapedectomy.
Assuntos
Paralisia Facial/etiologia , Herpes Zoster da Orelha Externa/etiologia , Otosclerose/cirurgia , Cirurgia do Estribo/efeitos adversos , Zoster Sine Herpete/diagnóstico , Aciclovir/administração & dosagem , Aciclovir/uso terapêutico , Antivirais/uso terapêutico , Nervo Facial/patologia , Nervo Facial/virologia , Paralisia Facial/diagnóstico , Paralisia Facial/fisiopatologia , Paralisia Facial/virologia , Feminino , Herpes Zoster da Orelha Externa/classificação , Herpes Zoster da Orelha Externa/diagnóstico , Herpes Zoster da Orelha Externa/tratamento farmacológico , Herpesvirus Humano 3/isolamento & purificação , Herpesvirus Humano 3/patogenicidade , Humanos , Incidência , Pessoa de Meia-Idade , Otosclerose/classificação , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/virologia , Estudos Retrospectivos , Cirurgia do Estribo/métodos , Fatores de Tempo , Resultado do Tratamento , Ativação Viral , Zoster Sine Herpete/complicações , Zoster Sine Herpete/tratamento farmacológicoRESUMO
El síndrome Ramsay-Hunt asocia parálisis facial periférica acompañada de una erupción vesicular en pabellón auricular o cavidad oral, causada por la afectación del ganglio geniculado por el virus varicela-zóster. La afectación facial en el zóster ótico es inicialmente más severa y con peor pronóstico de recuperación que la parálisis de Bell. El tratamiento precoz de esta enfermedad suele incluir aciclovir intravenoso u oral, analgésicos, corticoides y medidas de protección ocular; encaminado todo ello a mejorar el pronóstico de curación. Presentamos un caso de síndrome de Ramsay-Hunt en una mujer de 65 años con mala evolución (AU)
Ramsay-Hunt syndrome is peripheral facial palsy combined with a vesicular rash in the pinna or oral cavity. It is caused by the varicella zoster virus infection of the geniculate ganglion. Facial condition in the Zoster Oticus initially has a more severe and worse prognosis of recovery from Bell's palsy. Early treatment of this pathology usually consists of intravenous treatment or oral acyclovir, analgesics, corticosteroids and eye protection measures, in order to improve the probability of cure. We present a case of Ramsay-Hunt syndrome with a poor outcome in a 65 year-old woman (AU)
