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KMID : 0858620070110020095
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Korean Journal of Audiology
2007 Volume.11 No. 2 p.95 ~ p.100
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The Audiologic Assessment in Ramsay Hunt Syndrome
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Jung Jin-Sei
Kim Jin
Chung Sa-Myoung
Lee Won-Sang
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Abstract
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Background and Objectives : Reactivation of endogenous latent Varicella-zoster virus (VZV) within the geniculate ganglion results in herpes zoster oticus that is characterized by a painful, unilateral vesicular eruption and facial paralysis. Ramsay-Hunt syndrome is frequently complicated by disorders of the 8th cranial nerve, such as hearing loss, tinnitus and vertigo. The mechanism by which VZV reactivation causes such cochlear symptoms remains to be understood. The present study analyzed the clinical features of cochlear function in Ramsay-Hunt syndrome.
Subjects and Methods : The charts of 169 patients with Ramsay-Hunt syndrome, who visited Yonsei University Health system were reviewed. 9 of them were excluded due to prior history of hearing impair-ment or chronic otitis media in the lesion side. The patients were divided according to the severity of facial paralysis based on the system proposed by House and Brackmann. Pure tone audiometry was conducted at the frequencies of 0.25, 0.5, 1, 2, 4 and 8 KHz. Acoustic thresholds of the affected ears were compared with those of the contralateral ears (normal ears) at each frequency level. Acoustic thresholds were analyzed according to the patient age, the presence of the hearing loss, and the severity of the facial palsy. Also tinnitus as the cochlear symptom was surveyed by chart review.
Results: There was a significant difference in acoustic threshold between the affected ear and the normal ear all frequency whether cochlear symptoms was present or not. 67% of patients who had subjective hearing loss had abnormal audiometry. 19% of patients who did not have subjective hearing loss had abnormal audiometry. But there was no correlation between the degree of hearing loss and the severity of the facial palsy. The hearing loss was more severe at the high frequency than lower frequency in the lesion side. Also was more exacerbated with aging process according to our date.
Conclusion: The hearing impairment in Ramsay-Hunt syndrome was more common than expected. Although the mechanism of cochlear symptoms in Ramsay-Hunt syndrome has not yet been understood, the characteristics of VZV can be more elucidated through the audiologic assessment.
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KEYWORD
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Herpes zoster oticus, Facial paralysis, Hearing loss, Puretone audiogram
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