Statistical Analysis of Pure Tone Audiometry and Caloric Test in Herpes Zoster Oticus

김진,이원상,문인석,이호기,정진세 대한이비인후과학회 2008 Clinical and Experimental Otorhinolaryngology Vol.1 No.1

Objectives. Pure tone audiometry and caloric test in patients with herpes zoster oticus were performed to determine the biologic features of the varicella zoster virus (VZV) and the pathogenesis of vestibulocochlear nerve disease in herpes zoster oticus. Study Design. A retrospective chart review of 160 patients with herpes zoster oticus was designed in order to determine the classic characteristics of vestibulocochlear nerve disease associated with the syndrome. Speech frequency and isolated high frequency acoustic thresholds were analyzed based on severity of facial paralysis and patient age. Patients without cochlear symptoms were selected randomly, and audiological function was evaluated. Patients with symptoms of vestibular dysfunction underwent the caloric test, and canal paresis was analyzed according to the severity of facial paralysis and the age of each patient. Results. Among the 160 patients, 111 exhibited pure tone audiometry; 26 (79%) of the patients with cochlear symptoms and 44 (56%) of the patients without cochlear symptoms had abnormal audiological data. Among the patients without cochlear symptoms, 15 (19%) had hearing loss at speech frequency, and 42 (54%) had hearing loss isolated to high frequency. The incidence of cochlear symptoms in herpes zoster oticus was not related to the severity of facial paralysis. The incidence of patients with isolated high frequency hearing loss statistically increased with age, however the incidence of patients with speech frequency hearing loss did not increase. Thirteen patients complained vertigo, and the incidence of vestibular disturbances and the value of canal paresis in the caloric test increased to statistical significance in parallel with increasing severity of facial paralysis. Conclusion. Mild or moderate cochlear symptoms with high frequency hearing loss were related to age, and severe vestibular symptoms were related to the severity of facial paralysis after onset of herpetic symptoms. This study might suggest us a clue to the pathogenesis of vestibulocochlear nerve disease in herpes zoster oticus. Objectives. Pure tone audiometry and caloric test in patients with herpes zoster oticus were performed to determine the biologic features of the varicella zoster virus (VZV) and the pathogenesis of vestibulocochlear nerve disease in herpes zoster oticus. Study Design. A retrospective chart review of 160 patients with herpes zoster oticus was designed in order to determine the classic characteristics of vestibulocochlear nerve disease associated with the syndrome. Speech frequency and isolated high frequency acoustic thresholds were analyzed based on severity of facial paralysis and patient age. Patients without cochlear symptoms were selected randomly, and audiological function was evaluated. Patients with symptoms of vestibular dysfunction underwent the caloric test, and canal paresis was analyzed according to the severity of facial paralysis and the age of each patient. Results. Among the 160 patients, 111 exhibited pure tone audiometry; 26 (79%) of the patients with cochlear symptoms and 44 (56%) of the patients without cochlear symptoms had abnormal audiological data. Among the patients without cochlear symptoms, 15 (19%) had hearing loss at speech frequency, and 42 (54%) had hearing loss isolated to high frequency. The incidence of cochlear symptoms in herpes zoster oticus was not related to the severity of facial paralysis. The incidence of patients with isolated high frequency hearing loss statistically increased with age, however the incidence of patients with speech frequency hearing loss did not increase. Thirteen patients complained vertigo, and the incidence of vestibular disturbances and the value of canal paresis in the caloric test increased to statistical significance in parallel with increasing severity of facial paralysis. Conclusion. Mild or moderate cochlear symptoms with high frequency hearing loss were related to age, and severe vestibular symptoms were related to the severity of facial paralysis after onset of herpetic symptoms. This study might suggest us a clue to the pathogenesis of vestibulocochlear nerve disease in herpes zoster oticus.

재발성 이성대상포진과 동반된 성대마비 없는 대상포진 인후두염 1예

차은주,정유진,조현호 대한후두음성언어의학회 2019 대한후두음성언어의학회지 Vol.30 No.1

Herpes zoster oticus is one of complication of varicella zoster virus (VZV) reactivation in the geniculate ganglion of the facial nerve, which is the most common presentation of herpes zoster in the head and neck region. However, VZV infection of the larynx has rarely been described in the literature compared with Herpes zoster oticus. Moreover, zoster laryngopharyngitis simultaneously occurred with recurred Herpes zoster oticus which has no newly developing motor dysfunction has not been reported yet. Therefore, these diseases are difficult to diagnose due to its rareness. However, distinctive appearances such as unilateral herpetic mucosal eruptions and vesicles are useful and essential in making a quick and accurate diagnosis. Thus, we report a characteristic case of zoster laryngopharyngitis simultaneously occurred with recurred Herpes zoster oticus not accompanied by any newly developing motor palsy.

이성대상포진에서 성상신경차단술의 치료 효과에 대한 고찰

배창훈,이석춘,최영호,천승민,백운회,정은채,송시연,김용대 대한이비인후과학회 2006 대한이비인후과학회지 두경부외과학 Vol.49 No.11

Background and Objectives:Facial palsy of herpes zoster oticus has rapid onset, is usually severe in degree, and poorer inprognosis than Bells palsy. In the past, herpes zoster oticus has usually been treated with acyclovir and steroid, but recently,applying stellate ganglion block for herpes zoster oticus has been recognized as an additional treatment that may improvefacial palsy. This study was designed to evaluate the effect of stellate ganglion block on herpes zoster oticus. Subjects andMethod:We reviewed retrospectively the medical records of 30 patients with herpes zoster oticus who were treated withacyclovir, steroid and stellate ganglion block between January 1995 and December 2004. The follow-up period was at leastover than 6 months. Results:All patients suffered from otalgia, vesicle, and facial palsy. The average degree of House-Brackmann classification on admission was 3.26 in the complete recovery patients and 4.61 in the incomplete recovery patients.Seventeen patients were completely recovered from facial palsy (56.7%), and 13 showed residual facial palsy 13 patients(43.3%). The poor prognosis may be related with early onset of facial palsy, high degree of House-Brackmann classificationon admission and high degenerative ratio on electroneurography of facial nerve. Conclusion:The additional treatment ofstellate ganglion block in herpes zoster oticus may not be effective on improving the complete recovery rate and prognosis.(Korean J Otolaryngol 2006;49:1065-70)

벨마비 및 이성대상포진 환자에서 예후인자에 대한 분석

이동희,전범조,이동호,홍성진,장기홍,여상원 대한이비인후과학회 2005 대한이비인후과학회지 두경부외과학 Vol.48 No.9

Background and Objectives:We evaluated the prognostic factors in Bell’s palsy and Ramsay-Hunt’s syndrome. Study design:We carried out a retrospective case review in a university-based hospital. Subjects and Method:Treatment consisted uniformly of high-dose prednisolone, dextran, vasodilators, carbogen therapy, and stellate ganglion block. In the case of Ramsay-Hunt’s syndrome, acyclovir was administered. The recovery of facial nerve function was documented according to the House-Brackmann grading system. All patients were followed up until recovery or at least up to 3 months. Results:The recovery rates to achieve the House-Brackmann grade II or better were 96.3% in Bells palsy and 84.6% in herpes zoster oticus. In herpes zoster oticus, older patients had poorer initial and final status (p=0.046, p=0.020), as well as less probability of complete recovery (p=0.025) than the younger patients. The herpes zoster oticus patients without diabetus mellitus showed more probability of recovery (p=0.018), higher degree of recovery (p=0.025), and better final status (p=0.012). Also herpes zoster oticus patients without essential hypertension had the higher degree of recovery rate (p=0.019). The herpes zoster oticus patients without vertigo showed more probability of recovery (p=0.005). Conclusion:No prognostic factors were found in Bell’s palsy. The prognostic factors of herpes zoster oticus were age, diabetus mellitus, essential hypertension and vertigo.

안면 신경 마비 환자의 측두골 자기공명영상 소견:벨마비 및 귀 대상포진의 비교

박시내,김현수,정소령,박경호,김범수,곽봉기,박준욱,이석은,여상원 대한이비인후과학회 2005 대한이비인후과학회지 두경부외과학 Vol.48 No.7

Background and Objectives:Magnetic resonance imaging (MRI) is a valuable and important tool for use in diagnosing and investigating diseases affecting the facial nerve. However, there are few reports investigating the difference in the MRI findings of Bell’s palsy and Ramsay Hunt syndrome. in order to evaluate the difference in the clinical values regarding these two groups of facial nerve palsy syndrome. In this study, we observed the MRI findings to investigate the value of MRI and its clinical significance in those two different groups of facial nerve palsy. Subjects and Method:Fourty-eight patients of Bell’s palsy or herpes zoster oticus, who were admitted to Kangnam St. Mary’s Hospital from January 1998 to December 2003, were selected to assess the results of gadolinium enhanced MRI. The frequency and the site of the facial nerve enhancement and its correlation with electroneuronography (ENoG), the time interval of the palsy to MRI, and initial ESR levels were observed in both groups of facial nerve palsy. Results:On gadolinium enhanced MRI, 16 of 24 patients with Bell’s palsy and 22 of 24 patients with herpes zoster oticus had contrast enhancement in the meatal, labyrinthine segments and geniculate ganglion. The number of enhanced segments was significantly larger in the patients with herpes zoster oticus than in the patients with Bells palsy (p<0.05). There has been significant correlation between the number of enhanced segment of the facial nerve and the result of ENoG in the patients with herpes zoster oticus (p<0.05). Conclusion:Gadolinium enhanced MRI (Gd-MRI) studies may predict the extent of lesion within the course of the facial nerve and its clinical value as a prognostic factor could be suggested in patients with herpes zoster oticus.

중이수술 후 대상포진 바이러스 재활성에 의한 지연성 안면신경 마비

조창건 대한이비인후과학회 2008 대한이비인후과학회지 두경부외과학 Vol.51 No.9

Herpes viral reactivation is thought to be an important etiologic factor in the development of post-operative delayed onset of facial paralysis. The authors present a case of herpes zoster oticus that occurred as a consequence of middle ear and mastoid surgery. The patient was initially misdiagnosed as iatrogenic facial paralysis and treated with oral steroid only. The final diagnosis of herpes zoster oticus was made by the development of herpetic auricular eruption with severe otalgia and the results of positive serological tests. Clinical features, diagnosis and management of this rare case are presented and discussed. (Korean J Otorhinolaryngol-Head Neck Surg 2008;51:829-32)

만성 간염환자의 이성(耳性) 대상포진 치험 1례

김민희,김자혜,윤화정,고우신,Kim, Min-Hi,Kim, Ja-Hye,Yoon, Hwa-Jung,Ko, Woo-Shin 대한한방안이비인후피부과학회 2005 한방안이비인후피부과학회지 Vol.18 No.2

A female visited the Dept. of Oriental Ophthamology & Otolaryngology & Dermatology, Dong-eui University with Facial Nerve Palsy in Herpes Zoster Oticus. She had been taking ill with chronic hepatitis B and taking western medicine. We treated a patient with only Oriental Medicine.(the herbal medication and acupuncture etc). Because she was afraid of herbal medicine -induced hepatitis, went through an examination about LFT profile regularly. The symptom of Herpes Zoster Oticus was improved and there was no abnormality in LFT profile. Through this case, we thought that it is possible to treat the other disease of the patient with chronic hepatitis using herbal medication without hepatotoxic hepatitis. But for the safety of patient and doctor in several case, we need to accumulate objective data about the side effect of herbal medications inducing hepatotoxic hepatitis.

이성대상포진으로 인한 구안와사 환자 1례 - 서양의학적 치료에 호전이 적은 환자를 중심으로

강래엽,김현진,한효정,박은영,장정아,강현선,김진원,서호석,Kang, Rae-Yeop,Kim, Hyun-Jin,Han, Hyo-Jung,Park, Eun-Young,Jang, Jeong-A,Kang, Hyun-Sun,Kim, Jin-Won,Seo, Ho-Seok 대한한의학방제학회 2009 大韓韓醫學方劑學會誌 Vol.17 No.2

Objectives : This study was designed to evaluate the effects of oriental medical treatments on the facial nerve palsy in Herpes Zoster Oticus. Methods : Subjects were 1 patients with the facial nerve palsy in Herpes Zoster Oticus. She had improved slightly still she had be gotten the medical services on inpatient states for 2 month. We gave Kamiligigepung-san to the patient 90 minutes after each meal and tried acupuncture 2 times every day. And we had evaluated the conditions of the patient using VAS, House-Brackmann Grade and Yanagihara scale. Results : After the comparison between an admission and discharge date at VAS, House-Brackmann Grade and Yanagihara scale, the facial nerve palsy of the patient had improved. Conclusions : It is effective the Kamiligigepung-san and Acupuncture on the facial nerve palsy in Herpes Zoster Oticus.

벨마비 및 이성대상포진 환자에서 예후인자로서의신경전도검사의 유용성

이동희,전범조,오현진,이동호,홍성진,이석은,여상원 대한이비인후과학회 2005 대한이비인후과학회지 두경부외과학 Vol.48 No.10

Background and Objectives:This study evaluated the usefullness of electroneurography (ENoG) as a prognostic indicator in Bell’s palsy and Ramsay-Hunt’s syndrome. Subjects and Method:Retrospective case-series review in a university-based hospital. The treatment consisted uniformly of high-dose prednisolone, dextran, vasodilators, carbogen therapy, and stellate ganglion block. Acyclovir was administered in the case of Ramsay-Hunts syndrome. ENoG was performed 7 to 10 days in Bells palsy and 10 to 14 days in Ramsay-Hunts syndrome. The recovery of the facial nerve function was documented using the House-Brackmann grading system. All patients were followed up until they recovered or at least for 3 months. Results:The recovery rates to House- Brackmann grade II or better were 96.3% in Bell’s palsy and 84.6% in herpes zoster oticus. There was no significant difference of ENoG value between recovery and non-recovery groups in Bell’s pasly and in herpes zoster oticus. The logistic regression model between ENoG values and the chance of recovery was not found in Bell’s palsy and in herpes zoster oticus. Conclusion:Although ENoG accurately predicts the percentage of remaining motor axons of the facial nerve, it cannot give a precise information on the prognosis or recovery rate of facial paralysis.

Ramsay Hunt syndrome 환자에 대한 證例報告

권강,박영환,Kwon, Kang,Park, Young-Hwan 대한한방안이비인후피부과학회 2001 한방안이비인후피부과학회지 Vol.14 No.2

Background: Ramsay Hunt syndrome is a disease that cause faical palsy, ear pain, ear vesicle, tinnitus, hardness of hearing by geniculate ganglion herpes. Ramsay Hunt syndrome could be taken two sides view of herpes zoster and facial palsy. In traditional oriental medicine Ramsay Hunt syndrome could be diagnosed as heat and dryness syndromes. Object: These studies are clinical observations about two Ramsay Hunt syndrome patient cases that is recovered under the treatment by herbal-acupuncture therapy and moxibustion. Methods: For treatment in acute state, acupuncture therapy was used and in convalescent stage, herbal acupuncture therapy and moxibustion therapy were used. For diagnosis system, House-Brackmann system, Yanagihara's system used as diagnosis scales. Result&Conclusion: The results as follows. 1. Generally, to treat Ramsay Hunt syndrome, it is knwon that from invasion of virus to period of first effect a short term bring about good result, but in these two cases, though a long term. considerable effect was braught out. 2. In treating two cases, herbal acupuncture therapys what are called CF, JSD were used. satisfactory results was produced.