Long-term Prognosis of Vertigo and Hearing Loss in Ramsay Hung Syndrome

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The long-term prognosis of vertigo and hearing loss in patients with Ramsay Hunt syndrome was examined in the present study. We treated 23 patients with facial palsy, herpes zoster oticus and vertigo and/or hearing loss with steroids and acyclovir at our university hospital between 1998 and 2000. Facial palsy and herpes zoster oticus were accompanied by vertigo in 11 patients and by sensorineural hearing loss in 7 patients. One year after onset, 4 of 11 patients with vertigo showed persistent severe CP (canal paresis). They had persistent head-shaking after nystagmus and were handicapped in their daily life due to dizziness. The prognosis of vertigo is similar to that of vestibular neuronitis, but unlike that of vertigo with sudden deafness, in which a lesion is likely present in the inner ear. This finding suggests that vertigo with Ramsay Hunt syndrome is due to a lesion of the vestibular nerve. One year after onset, all 7 patients with mild to moderate sensorineural hearing loss demonstrated by falling audiogram showed normal hearing irrespective of accompaniment of vertigo. The prognosis of sensorineural hearing loss is different from that of sudden deafness. This finding suggests that sensorineural hearing loss with Ramsay Hunt syndrome is due to a lesion of the cochlear nerve.
耳鼻咽喉科臨床学会の論文