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      Zona otitique, aspects cliniques et thérapeutiques: à propos d’un cas Translated title: Clinical and therapeutic features of herpes zoster oticus: a case report

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          Abstract

          Le zona auriculaire, également appelé « herpes zoster oticus » correspond à une infection virale par varicella-zoster virus (VZV) de l'oreille externe, moyenne et/ou interne. L'atteinte de l'oreille associée à une paralysie faciale correspond au syndrome de Ramsay-Hunt dont le diagnostic est clinique. Nous rapportons le cas d´un patient âgé de 25 ans qui a présenté un zona otitique associe à une paralysie faciale périphérique sans autres signes associés. A la lumière de cette observation et d´une revue de la littérature, on discutera les différents aspects cliniques, para-cliniques et évolutifs du zona otitique ainsi que l´attitude thérapeutique.

          Translated abstract

          Ear shingles, also called herpes zoster oticus, are a viral infection of the outer, middle and/or inner ear due to varicella zoster virus (VZV). Patients with ear involvement associated with facial palsy are clinically diagnosed with Ramsay-Hunt´s syndrome. We here report the case of a 25-year-old patient with herpes zoster oticus associated with peripheral facial palsy, without other associated signs. This study and literature review investigate the various clinical, para-clinical and evolutionary features of herpes zoster oticus and the therapeutic approaches.

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

          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.
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            Herpes zoster oticus: A rare clinical entity

            Herpes zoster oticus also known as Ramsay Hunt syndrome is a rare complication of herpes zoster in which reactivation of latent varicella zoster virus infection in the geniculate ganglion causes otalgia, auricular vesicles, and peripheral facial paralysis. Ramsay Hunt syndrome is rare in children and affects both sexes equally. Incidence and clinical severity increases when host immunity is compromised. Because these symptoms do not always present at the onset, this syndrome can be misdiagnosed. Although secondary to Bell's palsy in terms of the cause of acute atraumatic peripheral facial paralysis, Ramsay Hunt syndrome, with incidence ranged from 0.3 to 18%, has a worse prognosis. Herpes zoster oticus accounts for about 12% cases of facial palsy, which is usually unilateral and complete and full recovery occurs in only about 20% of untreated patients. The most advisable method to treat Ramsay Hunt syndrome is the combination therapy with acyclovir and prednisone but still not promising, and several prerequisites are required for better results. We present a case of 32-year-old man suffering from Ramsay Hunt syndrome with grade V facial palsy treated effectively with rehabilitation program, after the termination of the combination therapy of acyclovir and prednisone.
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              Zona auriculaire

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                Author and article information

                Journal
                Pan Afr Med J
                Pan Afr Med J
                PAMJ
                The Pan African Medical Journal
                The African Field Epidemiology Network
                1937-8688
                03 March 2022
                2022
                : 41
                : 171
                Affiliations
                [1 ]Service d’Otorhinolaryngologie et de Chirurgie Cervico-Faciale de l’Hôpital Militaire d’Instruction Mohamed V de Rabat, Faculté de Médecine et Pharmacie Rabat, Université Mohamed V Rabat, Rabat, Maroc
                Author notes
                [& ] Corresponding author: Ahmed Rouihi, Service d’Otorhinolaryngologie et de Chirurgie Cervico-Faciale de l’Hôpital Militaire d’Instruction Mohamed V de Rabat, Faculté de Médecine et Pharmacie Rabat, Université Mohamed V Rabat, Rabat, Maroc. ahmedrouihi@ 123456yahoo.fr
                Article
                PAMJ-41-171
                10.11604/pamj.2022.41.171.33711
                9074047
                35573434
                08288378-6651-41d3-80f7-564906523024
                Copyright: Ahmed Rouihi et al.

                The Pan African Medical Journal (ISSN: 1937-8688). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 10 February 2022
                : 15 February 2022
                Categories
                Case Report

                Medicine
                zona auriculaire,paralysie faciale périphérique,ramsay-hunt,cas clinique,herpes zoster oticus,peripheral facial paralysis,case report

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