Zoster oticus

Last Updated: 2019-08-26

Author(s): Anzengruber F., Navarini A.

ICD11: -

Ramsay Hunt syndrome, ear zoster, herpes zoster of the ear.

Herpes zoster infection in the auricle and surrounding area. The Hunt's zone includes the auricle, the tympanic membrane and the external auditory canal. In the case of involvement of the facial nerve and the vestibulocochlear nerve, dizziness, tinnitus and possibly also hearing loss, we speak of Ramsay-Hunt syndrome.

Diagnosis by the ENT physician!

Facial paralysis occurs in about 50-60% of cases.

  • About 1/3 of all patients remain deaf in the ear.

  • Some sources recommend a short-term administration of oral glucocorticoids (prednisolone 50 mg daily p.o.) in addition to antiviral therapy.

  • Introduction to ENT specialist 

  1. Al-Daraji, W.I., H.M. Ramsay, and R.B.M. Ali, Storiform collagenoma as a clue for Cowden disease or PTEN hamartoma tumour syndrome. Journal of Clinical Pathology, 2006. 60(7): p. 840-842.
  2. De, S. and A.G. Pfleiderer, An extreme and unusual variant of Ramsay Hunt syndrome. The Journal of Laryngology & Otology, 1999. 113(07).
  3. Huang, Y.C., S.J. Wang, and Y.H. Young, Test battery of cranial nerves VII and VIII for assessing herpes zoster oticus. Otolaryngol Head Neck Surg, 2015. 152(1): p. 143-8.
  4. Kansu, L. and I. Yilmaz, Herpes zoster oticus (Ramsay Hunt syndrome) in children: case report and literature review. Int J Pediatr Otorhinolaryngol, 2012. 76(6): p. 772-6.
  5. Dimisianos, N., et al., Trigeminal herpes zoster complicated by Ramsay Hunt syndrome. Neurologist, 2015. 19(2): p. 38-9.
  6. Rudd, T., et al., Mandibular osteonecrosis and Ramsay Hunt syndrome following a case of herpes zoster. J Oral Maxillofac Surg, 2014. 72(10): p. 1974 e1-6.
  7. Chung, M.S., et al., The clinical significance of findings obtained on 3D-FLAIR MR imaging in patients with Ramsay-Hunt syndrome. Laryngoscope, 2015. 125(4): p. 950-5.
  8. Lee, D.H., et al., Herpes zoster laryngitis accompanied by Ramsay Hunt syndrome. J Craniofac Surg, 2013. 24(5): p. e496-8.
  9. Iwasaki, H., et al., Vestibular and cochlear neuritis in patients with Ramsay Hunt syndrome: a Gd-enhanced MRI study. Acta Otolaryngol, 2013. 133(4): p. 373-7.
  10. Zhan, J., Z. Fu, and X. Wei, [Three cases of Ramsay-Hunt syndrome concurrent with ipsilateral vocal cord paralysis]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi, 2014. 28(8): p. 578-9.
  11. Rasmussen, E.R. and K. Mey, Vocal cord paralysis associated with Ramsay Hunt syndrome: looking back 50 years. BMJ Case Rep, 2014. 2014.
  12. Kim, C.H., et al., Vibration- and hyperventilation-induced nystagmus in patients with Ramsay Hunt syndrome with vertigo. Otolaryngol Head Neck Surg, 2015. 152(5): p. 912-8.
  13. Lee, E.J. and Y.J. Yoon, A case of generalized varicelliform eruption after herpes zoster oticus. Otol Neurotol, 2014. 35(1): p. e57-9.

  14. Werner RN, Nikkels AF, Marinovic B, Schafer M, Czarnecka-Operacz M, Agius AM, Bata-Csorgo Z, Breuer J, Girolomoni G, Gross GE, Langan S, Lapid-Gortzak R, Lesser TH, Pleyer U, Sellner J, Verjans GM, Wutzler P, Dressler C, Erdmann R, Rosumeck S, Nast A: European consensus-based (s2k) guideline on the management of herpes zoster - guided by the european dermatology forum (edf) in cooperation with the european academy of dermatology and venereology (eadv), part 1: Diagnosis. J Eur Acad Dermatol Venereol 2017;31:9-19.

  15. Werner RN, Nikkels AF, Marinovic B, Schafer M, Czarnecka-Operacz M, Agius AM, Bata-Csorgo Z, Breuer J, Girolomoni G, Gross GE, Langan S, Lapid-Gortzak R, Lesser TH, Pleyer U, Sellner J, Verjans GM, Wutzler P, Dressler C, Erdmann R, Rosumeck S, Nast A: European consensus-based (s2k) guideline on the management of herpes zoster - guided by the european dermatology forum (edf) in cooperation with the european academy of dermatology and venereology (eadv), part 2: Treatment. J Eur Acad Dermatol Venereol 2017;31:20-29.

  16. Werner RN, Nikkels AF, Marinovic B, Schafer M, Czarnecka-Operacz M, Agius AM, Bata-Csorgo Z, Breuer J, Girolomoni G, Gross GE, Langan S, Lapid-Gortzak R, Lesser TH, Pleyer U, Sellner J, Verjans GM, Wutzler P, Dressler C, Erdmann R, Rosumeck S, Nast A: European consensus-based (s2k) guideline on the management of herpes zoster - guided by the european dermatology forum (edf) in cooperation with the european academy of dermatology and venereology (eadv), part 1: Diagnosis. J Eur Acad Dermatol Venereol 2017;31:9-19.

  17. Werner RN, Nikkels AF, Marinovic B, Schafer M, Czarnecka-Operacz M, Agius AM, Bata-Csorgo Z, Breuer J, Girolomoni G, Gross GE, Langan S, Lapid-Gortzak R, Lesser TH, Pleyer U, Sellner J, Verjans GM, Wutzler P, Dressler C, Erdmann R, Rosumeck S, Nast A: European consensus-based (s2k) guideline on the management of herpes zoster - guided by the european dermatology forum (edf) in cooperation with the european academy of dermatology and venereology (eadv), part 2: Treatment. J Eur Acad Dermatol Venereol 2017;31:20-29.