Int. Adv. Otol. 2010; 6(3) 408-409

Ramsay Hunt and antivirals; the role of Evidence Based Medicine.
J.A. de Ru, P.P.G. van Benthem, M.C.J. Aarts  Centraal Militair Hospitaal, Utrecht, The Netherlands

The chance of full recovery of facial nerve function following paralysis due to a herpes zoster infection is small. Therefore, treatment is imperative.

A recently published systematic review published by the Cochrane Collaboration has caused us pause for thought. First of all, we disagree with the conclusion that was reached in this review that antivirals may not be helpful; we would even contend that treatment that does not include antivirals might result in severe morbidity.

Secondly, we are concerned about the current practice of only awarding value to randomised trials. Although methodology, of course, is of importance, we are of the opinion that more attention should be paid to the medical content in all of its facets. Otherwise, we will have to face the fact that the methodological Puritanism - which usually results in rather nihilistic behaviour due to the fact that for many diseases very little high-level evidence can be found - will take precedence at the cost of proper patient care.