Mauprivez Cédric, Comte Clément, Labrousse Marc, Khonsari Roman H
Associate Professor, Pôle d'Odontologie, Hôpital Maison Blanche, Centre Hospitalier Universitaire, Reims; Laboratoire EA 4691 Biomatériaux et Inflammation en Site Osseux, Université Reims Champagne-Ardennes, Reims, France.
Resident, Pôle d'Odontologie, Hôpital Maison Blanche, Centre Hospitalier Universitaire, Reims, France.
J Oral Maxillofac Surg. 2017 Sep;75(9):1906-1914. doi: 10.1016/j.joms.2017.02.025. Epub 2017 Mar 14.
Ramsay-Hunt syndrome (RHS) is a rare complication of herpes zoster in which reactivation of latent varicella zoster virus (VZV) infection occurs in the geniculate ganglion. Major clinical findings are peripheral facial nerve palsy accompanied by ipsilateral ear pain and erythematous vesicular rash on the external ear (herpes zoster oticus) and in the mouth. Thus, diagnosis of RHS is usually clinical. However, auricular herpetic eruption is not always present, making diagnosis more difficult. This report describes a case of RHS with left facial palsy without skin lesions in 60-year-old woman. Multiple ulcers were found on her left soft palate. Polymerase chain reaction analysis on oral mucosa biopsy samples and serologic assays allowed the identification of VZV as the causal agent. Knowledge of the anatomy of the facial nerve is important for oral and maxillofacial surgeons when dealing with patients with RHS, especially in unusual and clinically misleading forms of this syndrome.
拉姆齐-亨特综合征（RHS）是带状疱疹的一种罕见并发症，其中潜伏的水痘-带状疱疹病毒（VZV）感染在膝状神经节重新激活。主要临床发现为周围性面神经麻痹，伴有同侧耳部疼痛以及外耳（耳部带状疱疹）和口腔内的红斑水疱性皮疹。因此，RHS的诊断通常基于临床症状。然而，耳部疱疹性皮疹并不总是出现，这使得诊断更加困难。本报告描述了一名60岁女性患RHS伴左侧面神经麻痹但无皮肤病变的病例。在其左侧软腭发现多个溃疡。对口腔黏膜活检样本进行的聚合酶链反应分析和血清学检测确定VZV为致病因子。对于口腔颌面外科医生而言，了解面神经的解剖结构在处理RHS患者时非常重要，尤其是在该综合征的不寻常且具有临床误导性的形式中。
