Treatment and Prognosis of Facial Palsy on Ramsay Hunt Syndrome

Abstract

Objectives: Review the prognosis of facial palsy on Ramsay Hunt syndrome after the treatments proposed by different authors, based on a review of the literature. Methods: A search was performed in LILACS, SciELO, and PUBMED databases. The key words used on the search were: prognosis OR evolution AND ramsay-hunt OR herpes zoster oticus AND facial palsy OR facial paralysis. Results: Studies showed 882 patients with facial palsy secondary to Ramsay Hunt syndrome. Six hundred and twenty one (70.4%) of those patients achieved improvement on the House-Brackmann grade, achieving a grade score of I or II. Among the patients treated only with steroids, 68% got the same results, versus 70.5% of the patients treated with steroids plus antiviral agents. Of patients classified on the House-Brackmann grade as V or VI before treatment, 51.4% improved facial nerve function, achieving I or II on the HB scale. The treatment with methylprednisolone associated with acyclovir showed better results when compared with acyclovir associated with prednisone, prednisolone or hydrocortisone (81.3% versus 69.2%, 61.4% and 76.3%, respectively). Conclusions: Patients with Ramsay Hunt syndrome may achieve a good rate of facial recovery. The steroid associated with better results was methylprednisolone, and the association of steroids and acyclovir achieved better results than the patients who did not receive the antiviral agent.