ISSN 1308-7649 | E-ISSN 2148-3817
Original Article
Typical or Atypical Ramsay-Hunt Syndrome in Delayed Facial Palsy After Stapedectomy?
1 Department of Clinical Science and Community Health, University of Milan, Milano, Italy  
2 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
Key Words: Ramsay Hunt syndrome, zoster sine herpete, delayed facial palsy, stapedotomy, varicella zoster virus


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.

Key Words
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AVES | Copyright © 2018 The European Academy of Otology and Neurotology | Latest Update: 16.08.2018