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Int Arch Otorhinolaryngol 2016; 20(04): 394-400
DOI: 10.1055/s-0036-1584267
Systematic Review
Thieme Publicações Ltda Rio de Janeiro, Brazil

Treatment and Prognosis of Facial Palsy on Ramsay Hunt Syndrome: Results Based on a Review of the Literature

Rafael da Costa Monsanto
1   Department of Otolaryngology, Banco de Olhos de Sorocaba Hospital, Sorocaba, São Paulo, Brazil
,
Aline Gomes Bittencourt
1   Department of Otolaryngology, Banco de Olhos de Sorocaba Hospital, Sorocaba, São Paulo, Brazil
2   Department of Otolaryngology, School of Medicine, Universidade de São Paulo, São Paulo, Brazil
,
Natal José Bobato Neto
1   Department of Otolaryngology, Banco de Olhos de Sorocaba Hospital, Sorocaba, São Paulo, Brazil
,
Silvia Carolina Almeida Beilke
1   Department of Otolaryngology, Banco de Olhos de Sorocaba Hospital, Sorocaba, São Paulo, Brazil
,
Fabio Tadeu Moura Lorenzetti
1   Department of Otolaryngology, Banco de Olhos de Sorocaba Hospital, Sorocaba, São Paulo, Brazil
2   Department of Otolaryngology, School of Medicine, Universidade de São Paulo, São Paulo, Brazil
,
Raquel Salomone
1   Department of Otolaryngology, Banco de Olhos de Sorocaba Hospital, Sorocaba, São Paulo, Brazil
2   Department of Otolaryngology, School of Medicine, Universidade de São Paulo, São Paulo, Brazil
› Author Affiliations
Further Information

Publication History

17 March 2016

12 April 2016

Publication Date:
30 May 2016 (online)

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Abstract

Introduction Ramsay Hunt syndrome is the second most common cause of facial palsy. Early and correct treatment should be performed to avoid complications, such as permanent facial nerve dysfunction.

Objective The objective of this study is to review the prognosis of the facial palsy on Ramsay Hunt syndrome, considering the different treatments proposed in the literature.

Data Synthesis We read the abstract of 78 studies; we selected 31 studies and read them in full. We selected 19 studies for appraisal. Among the 882 selected patients, 621 (70.4%) achieved a House-Brackmann score of I or II; 68% of the patients treated only with steroids achieved HB I or II, versus 70.5% when treated with steroids plus antiviral agents. Among patients with complete facial palsy (grades V or VI), 51.4% recovered to grades I or II. The rate of complete recovery varied considering the steroid associated with acyclovir: 81.3% for methylprednisolone, 69.2% for prednisone; 61.4% for prednisolone; and 76.3% for hydrocortisone.

Conclusions Patients with Ramsay-hunt syndrome, when early diagnosed and treated, achieve high rates of complete recovery. The association of steroids and acyclovir is better than steroids used in monotherapy.

Keywords

prognosis - facial palsy - ramsay hunt syndrome - varicela zoster - house-brackmann
 

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