Original Article

Vol. 14 No. 2 (2018): The Journal of International Advanced Otology
DOI: https://doi.org/10.5152/iao.2018.3491

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Published: Sep 3, 2019
Keywords:
Ramsay Hunt syndrome, zoster sine herpete, delayed facial palsy, stapedotomy, varicella zoster virus

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Federica Di Berardino
Department of Clinical Science and Community Health, University of Milan, Milano, Italy
Diego Zanetti
Department of Surgical Sciences, Fondazione IRCCS “Cà Granda”, H. Maggiore Policlinico, Milano, Italy

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

Main Article Content

Federica Di Berardino
Department of Clinical Science and Community Health, University of Milan, Milano, Italy
Diego Zanetti
Department of Surgical Sciences, Fondazione IRCCS “Cà Granda”, H. Maggiore Policlinico, Milano, Italy

Abstract

Abstract


 



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.

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