title: Treatment and Prognosis of Facial Palsy on Ramsay Hunt Syndrome: Results Based on a Review of the Literature.
abstract: IntroductionRamsay 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.ObjectiveThe 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 SynthesisWe 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.ConclusionsPatients 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.
authors.affiliation: Department of Otolaryngology, Banco de Olhos de Sorocaba Hospital, Sorocaba, São Paulo, Brazil.
authors.forename: Rafael da Costa
authors.initials: RD
authors.lastname: Monsanto
authors.affiliation: Department of Otolaryngology, Banco de Olhos de Sorocaba Hospital, Sorocaba, São Paulo, Brazil; Department of Otolaryngology, School of Medicine, Universidade de São Paulo, São Paulo, Brazil.
authors.forename: Aline Gomes
authors.initials: AG
authors.lastname: Bittencourt
authors.affiliation: Department of Otolaryngology, Banco de Olhos de Sorocaba Hospital, Sorocaba, São Paulo, Brazil.
authors.forename: Natal José
authors.initials: NJ
authors.lastname: Bobato Neto
authors.affiliation: Department of Otolaryngology, Banco de Olhos de Sorocaba Hospital, Sorocaba, São Paulo, Brazil.
authors.forename: Silvia Carolina Almeida
authors.initials: SC
authors.lastname: Beilke
authors.affiliation: Department of Otolaryngology, Banco de Olhos de Sorocaba Hospital, Sorocaba, São Paulo, Brazil; Department of Otolaryngology, School of Medicine, Universidade de São Paulo, São Paulo, Brazil.
authors.forename: Fabio Tadeu Moura
authors.initials: FT
authors.lastname: Lorenzetti
authors.affiliation: Department of Otolaryngology, Banco de Olhos de Sorocaba Hospital, Sorocaba, São Paulo, Brazil; Department of Otolaryngology, School of Medicine, Universidade de São Paulo, São Paulo, Brazil.
authors.forename: Raquel
authors.initials: R
authors.lastname: Salomone
keywords: facial palsy; house-brackmann; prognosis; ramsay hunt syndrome; varicela zoster