Ramsay Hunt sendromunda kombine tedavi: Klinik ve prognozun değerlendirilmesi

Yıl 2014, Cilt: 4 Sayı: 3, - , 01.09.2014

Ercan Pınar Abdulkadir İmre Yüksel Olgun Ahmet Ata Ece Murat Songu Hale Aslan

https://doi.org/10.2399/jmu.2014003005

Öz

Amaç: Çalışmanın amacı Ramsay Hunt sendromu tanısı alan hastaların klinik özelliklerini, tedavi ve sonuçlarını retrospektif olarak analiz etmektir. Yöntem: Ramsay Hunt sendromlu 12 hasta retrospektif olarak analiz edildi. Hastaların cinsiyeti, yaşı, tedaviye ilk başvuru süresi ve klinik sonuçları kaydedildi. Fasiyal disfonksiyonun değerlendirilmesinde House-Brackmann evreleme sistemi kullanıldı. Bütün hastalar oral steroid ve acyclovir ile tedavi edildi. Bulgular: Hastalarımızın 7'si erkek, 5'i kadın idi. Hastalarımızın yaş ortalaması 59 olarak bulundu (21-68 arası). En önemli semptom akut fasiyal paralizi idi. Hastaların tedavi öncesi House-Brackmann skalası III ile VI arasında değişmekteydi. Tüm hastalarda ilk ortalama House-Brackmann skalası değeri 4.5, tedavi sonrası 2.33 idi. House Brackmann skalası V ve VI olan hastalarda fasiyal paralizinin dönme riski daha düşüktü. Sonuç: Ramsay Hunt sendromunda, fasiyal paralizinin prognozu ilk semptomlara ve klinik bulgulara bağlıdır. Prognoz ciddi paralizi ve komorbid hastalığı olanlarda daha kötüdür.

Anahtar Kelimeler

Ramsay Hunt sendromu, tedavi, prognoz

Combined treatment in Ramsay Hunt syndrome: evaluation of clinic and prognosis

Öz

Objective: We retrospectively analysed clinical characteristics, treatment and outcomes of the patients with Ramsay Hunt syndrome. Methods: Twelve patients with Ramsay Hunt syndrome were analysed retrospectively. Data recorded included sex, age, time from first onset to initial treatment and clinical outcomes. The House-Brackmann scale was used to assess initial facial nerve dysfunction and final facial nerve impairment. All patients were treated with oral steroids and oral acyclovir. Results: There were 7 male and 5 female patients. Mean age was 59 (range: 21 to 68) years. The main symptom was acute facial palsy. House-Brackmann classification of facial nerve function ranged from grade III to VI before treatment. The median baseline House-Brackmann grade was 4.5 and it was 2.33 after the treatment in all patients. Recovery rate of facial palsy was lower in patients with House-Brackmann grades V and VI. Conclusion: In this syndrome, the prognosis of facial palsy depends on the initial symptoms and clinical findings. The prognosis was poorer in severe palsy and patients with comorbid disease(s).

Anahtar Kelimeler

Ramsay Hunt syndrome, treatment, prognosis

Kaynakça

• Robillard RB, Hilsinger RL, Adour KK. Ramsay Hunt facial paralysis: clinical analyses of 185 patients. Otolaryngol Head Neck Surg 1986:95;292–7.
• Adour KK. Otologic complications of herpes zoster. Ann Neurol 1994;35:62–4.
• Kansu L, Yilmaz I. Herpes zoster oticus (Ramsay Hunt syn- drome) in children: case report and literature review. Int J Ped Otorhinolaryngol 2012:76;772–6.
• Ko JY, Sheen TS, Hsu MM. Herpes zoster oticus treated with acyclovir and prednisolone: clinical manifestations and analysis of prognostic factors. Clin Otolaryngol Allied Sci 2000;25:139–42.
• Wagner G, Klinge H, Max Sachse M. Ramsay Hunt syndrome. J Dtsch Dermatol Ges 2012;10:238–43.
• Kinishi M, Amatsu M, Mohri M, Saito M, Hasegawa T, Hasegawa S. Acyclovir improves recovery rate of facial nerve palsy in Ramsay Hunt syndrome. Auris Nasus Larynx 2001;28:223–6.
• Uscategui T, Doree C, Chamberlain IJ,Burton MJ. Antiviral ther- apy for Ramsay Hunt syndrome (herpes zoster oticus with facial palsy) in adults. Cochrane Database Syst Rev 2008;8(4): CD006851.
• Lee DH, Chae SY, Park YS, Yeo SW. Prognostic value of elec- troneurography in Bell’s palsy and Ramsay-Hunt’s syndrome. Clin Otolaryngol 2006;31:144–8.
• Zainine R, Sellami M, Charfeddine A, Beltaief N, Sahtout S, Besbes G. Ramsay Hunt syndrome. Eur Ann Otorhinolaryngol Head Neck Dis 2012;129:22–5.
• Coulson S, Croxson GR, Adams R, Oey V. Prognostic factors in herpes zoster oticus (Ramsay Hunt syndrome). Otol Neurotol 201;32:1025–30.
• Yeo SW, Lee DH, Jun BC, Chang KH, Park YS. Analysis of prog- nostic factors in Bell’s palsy and Ramsay Hunt syndrome. Auris Nasus Larynx 2007;34:159–64.
• Anpalahan V, Redhead J. Acyclovir and prednisolone combination treatment in Bell’s palsy. Aust J Otolaryngol 2000;3:476–8.
• Byun H, Cho YS, Jang JY, Chung KW, Hwang S, Chung WH, Hong SH. Value of electroneurography as a prognostic indicator for recovery in acute severe inflammatory facial paralysis: a prospective study of Bell’s palsy and Ramsay Hunt syndrome. Laryngoscope 2013;123:2526–32.
• Morishima N, Yagi R, Shimizu K, Ota S. Prognostic factors of synkinesis after Bell’s palsy and Ramsay Hunt syndrome. Auris Nasus Larynx 2013;40:431–4.
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• Please cite this article as: Pınar E, ‹mre A, Olgun Y, Ece AA, Songu M, Aslan H. Combined treatment in Ramsay Hunt syndrome: evaluation of clinic and
• prognosis. J Med Updates 2014;4(3):110–112.