Koudounarakis E, Balamatsis Z, Xenaki E, Kyrmizakis D E
Department of Otorhinolaryngology, General Hospital of Rethymno, Crete, Greece.
B-ENT. 2011;7(4):293-5.
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.
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.
The clinical presentation suggested varicella-zoster virus reactivation, which was confirmed serologically, and appropriate treatment was administered.
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.
我们报告一例正在接受血液透析的慢性肾病患者同时出现单侧面部神经和喉上神经受累的临床病例。
一名75岁慢性肾衰竭男性因严重吞咽痛转诊至我科。在软性内镜检查期间，发现其右侧声门上区喉黏膜有水泡。两天后，该患者出现周围性面神经麻痹并伴有轻度耳部皮疹。
临床表现提示水痘-带状疱疹病毒再激活，血清学检查得以证实，并给予了适当治疗。
带状疱疹感染可能累及不止一条颅神经，尤其是在慢性肾衰竭等易感患者中。即使没有声音嘶哑，在出现吞咽痛和咽痛的病例中怀疑喉上神经受累也很重要。
