title: Herpes zoster laryngitis and Ramsay-Hunt syndrome in a patient with chronic renal failure.
abstract: OBJECTIVE
  We report on a clinical case of simultaneous and unilateral involvement of the facial and superior laryngeal nerve in a patient with chronic renal disease undergoing haemodialysis.
  
  
  METHODS
  A 75-year-old man with chronic renal failure was referred to our department suffering from severe odynophagia. During flexible endoscopy, vesicles were found on the mucosa of his right supraglottic larynx. Two days later, peripheral facial nerve palsy with a mild auricular rash appeared in the patient.
  
  
  RESULTS
  The clinical presentation suggested varicella-zoster virus reactivation, which was confirmed serologically, and appropriate treatment was administered.
  
  
  CONCLUSIONS
  Involvement of more than one cranial nerve in herpes zoster infection is possible, especially in vulnerable patients such as those with chronic renal failure. It is also important to suspect involvement of the superior laryngeal nerve in cases of odynophagia and throat pain, even when hoarseness is absent.
authors.affiliation: Department of Otorhinolaryngology, General Hospital of Rethymno, Crete, Greece. ekoudounarakis@hotmail.com
authors.forename: E
authors.initials: E
authors.lastname: Koudounarakis
authors.forename: Z
authors.initials: Z
authors.lastname: Balamatsis
authors.forename: E
authors.initials: E
authors.lastname: Xenaki
authors.forename: D E
authors.initials: DE
authors.lastname: Kyrmizakis
mesh_terms: D000368:Aged; D015897:Comorbidity; D006562:Herpes Zoster / Q000453:epidemiology*; D016697:Herpes Zoster Oticus / Q000453:epidemiology*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology*; D007827:Laryngitis / Q000453:epidemiology* / Q000821:virology*; D008297:Male