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.
MeSH terms
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Acyclovir / administration & dosage
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Acyclovir / therapeutic use
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Antiviral Agents / therapeutic use
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Facial Nerve / pathology
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Facial Nerve / virology
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Facial Paralysis / diagnosis
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Facial Paralysis / etiology*
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Facial Paralysis / physiopathology
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Facial Paralysis / virology
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Female
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Herpes Zoster Oticus / classification
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Herpes Zoster Oticus / diagnosis
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Herpes Zoster Oticus / drug therapy
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Herpes Zoster Oticus / etiology*
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Herpesvirus 3, Human / isolation & purification
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Herpesvirus 3, Human / pathogenicity
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Humans
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Incidence
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Middle Aged
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Otosclerosis / classification
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Otosclerosis / surgery*
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Postoperative Complications / etiology
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Postoperative Complications / virology
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Retrospective Studies
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Stapes Surgery / adverse effects*
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Stapes Surgery / methods
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Time Factors
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Treatment Outcome
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Virus Activation
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Zoster Sine Herpete / complications
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Zoster Sine Herpete / diagnosis*
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Zoster Sine Herpete / drug therapy
Substances
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Antiviral Agents
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Acyclovir