Combined treatment in Ramsay Hunt syndrome: evaluation of clinic and prognosis

Ramsay Hunt syndrome (RHS) is a disease with involvement of the seventh and eighth cranial nerves and characterized by acute facial palsy and inner ear dysfunction with a herpetic eruption on the auricula and external ear canal.Ramsay Hunt reported the first case in 1907.This syndrome is caused by reactivation of the latent varicella zoster virus in the geniculate ganglion of the facial nerve.[1] This syndrome represents the second most common cause of atraumatic peripheral facial palsy.It is responsible for 2-10% of all cases of acute peripheral facial palsy.[2] The treatment of this syndrome is empiric.Various authors have reported several treatment protocols including corticosteroids, vasodilators and antiviral agents.[3][4][5] The present study describes the clinical presentation, treatment and clinical outcomes of this rare disease.Özet Amaç: Çal›flman›n amac› Ramsay Hunt sendromu tan›s› alan hastala-r›n klinik özelliklerini, tedavi ve sonuçlar›n› retrospektif olarak analiz etmektir.Yöntem: Ramsay Hunt sendromlu 12 hasta retrospektif olarak analiz edildi.Hastalar›n cinsiyeti, yafl›, tedaviye ilk baflvuru süresi ve klinik sonuçlar› kaydedildi.Fasiyal disfonksiyonun de¤erlendirilmesinde House-Brackmann evreleme sistemi kullan›ld›.Bütün hastalar oral steroid ve acyclovir ile tedavi edildi.Bulgular: Hastalar›m›z›n 7'si erkek, 5'i kad›n idi.Hastalar›m›z›n yafl ortalamas› 59 olarak bulundu (21-68 aras›).En önemli semptom akut fasiyal paralizi idi.Hastalar›n tedavi öncesi House-Brackmann skalas› III ile VI aras›nda de¤iflmekteydi.Tüm hastalarda ilk ortalama House-Brackmann skalas› de¤eri 4.5, tedavi sonras› 2.33 idi.House Brackmann skalas› V ve VI olan hastalarda fasiyal paralizinin dönme riski daha düflüktü.