The Journal of International
Advanced Otology
Original Article

Typical or Atypical Ramsay-Hunt Syndrome in Delayed Facial Palsy After Stapedectomy?


Department of Clinical Science and Community Health, University of Milan, Milano, Italy


Department of Surgical Sciences, Fondazione IRCCS “Cà Granda”, H. Maggiore Policlinico, Milano, Italy

J Int Adv Otol 2018; 14: 233-238
DOI: 10.5152/iao.2018.3491
Read: 1648 Downloads: 667 Published: 03 September 2019



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.

EISSN 2148-3817