Department of Otorhinolaryngology-Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, PO Box 263, 00029 HUS, Helsinki, Finland.
Terveystalo Occupational Healthcare Services, Leppavaara and Espoontori, Espoo, Finland.
目的探讨Ramsay Hunt综合征的特征，药物治疗和长期面瘫。方法患者问卷包括对长期面部麻痹预后的自我评估和回顾性图表审查。将最初的面部麻痹等级与自我评估或患者记录中记载的麻痹预后进行比较。对综合征的不同特征（水疱，听力损失，眩晕等）的发生情况进行了评估。结果共纳入120例患者，其中81人回答了问卷。除一名患者外，所有患者均已接受病毒药物治疗（阿昔洛韦，伐昔洛韦），一半患者同时接受皮质类固醇激素治疗。如果在拉姆齐·亨特（Ramsay Hunt）诊断后72小时内开始用药，则超过80％的患者的面神经麻痹全部恢复或仅有轻微后遗症。只有少数患者同时出现水痘和面神经麻痹，水疱更经常发生在麻痹之前或之后。大约20％的患者的水泡在耳道或口腔的隐蔽位置。结论在药物治疗的拉姆齐·亨特综合征中，面神经麻痹的长期预后接近贝尔麻痹的预后。向患者询问和了解水泡并寻找它们是至关重要的，因为水泡通常发生在麻痹之前或之后，并且可能会出现在不容易看到的区域。结论在药物治疗的拉姆齐·亨特综合征中，面神经麻痹的长期预后接近贝尔麻痹的预后。向患者询问和了解水泡并寻找它们是至关重要的，因为水泡经常出现在麻痹之前或之后，并且可能会出现在不容易看到的区域。结论在药物治疗的拉姆齐·亨特综合征中，面神经麻痹的长期预后接近贝尔麻痹的预后。向患者询问和了解水泡并寻找它们是至关重要的，因为水泡通常发生在麻痹之前或之后，并且可能会出现在不容易看到的区域。
PURPOSE
To explore the characteristics, medical treatments, and long-term facial palsy outcome in Ramsay Hunt syndrome.
METHODS
Patient questionnaire including self-assessment of long-term facial palsy outcome and retrospective chart review. Initial facial palsy grade was compared to self-assessed or patient record stated palsy outcome. Occurrence of different characteristics (blisters, hearing loss, vertigo, etc.) of the syndrome were assessed.
RESULTS
Altogether 120 patients were included of which 81 answered the questionnaire. All but one patient had received virus medication (aciclovir, valaciclovir), and half received simultaneous corticosteroids. If the medication was started within 72 h of Ramsay Hunt diagnosis, facial palsy recovered totally or with only slight sequelae in over 80% of the patients. Only a minority of the patients experienced varicella blisters simultaneously with facial palsy, blisters more often preceded or followed the palsy. Approximately 20% of the patients had their blisters in hidden places in the ear canal or mouth.
CONCLUSIONS
The long-term outcome of facial palsy in medically treated Ramsay Hunt syndrome was approaching the outcome of Bell's palsy. It is crucial to ask and inform the patient about the blisters and look for them since, more often than not, the blisters precede or follow the palsy and can be in areas not easily seen.
