耳带状疱疹综合征的临床诊断和治疗

Diagnosis and Management of Ramsay-Hunt Syndrome

目的探讨耳带状疱疹综合征的临床诊断和治疗体会。方法回顾性分析我院耳带状疱疹综合征的临床资料36例。(随机)结果全部病例均有耳部疱疹、耳痛及面瘫,其中12例有不同程度的眩晕、眼震及平衡失调。经口服类固醇激素和抗病毒等药物,患者面瘫完全恢复者27例,部分恢复者9例。面瘫完全恢复者,听力各频率有提高;面瘫部分恢复者,听力各频率有提高;听力改善与面瘫恢复呈正相关(P﹤0.01),特别是言语频率听力提高面瘫恢复成正相关(P﹤0.01)。眩晕,眼震及平衡失调随面瘫好转而消失。结论耳带状疱疹综合征临床诊断应与贝尔面瘫鉴别,及时采用综合的药物治疗,能够取得良好的治疗效果。耳带状疱疹综合征患者言语频率明显改善者预示面神经恢复较好。

Objective To report the authors＇ experiences with diagnosis and management of Ramsay-Hunt Syn- drome. Method Clinical data of 36 patients with Ramsay-Hunt Syndrome were reviewed（random）. Result All the patients presented with herpes zoster oticus, earache and facial palsy. Some patients （n=12） also reported vertigo or dysequilibrium of various degrees, some with nystagmus. The facial nerve function fully recovered in 27 patients following treatment with steroid and antivirals, with also significant hearing improvement. Partial recovery was noticed in 9 patients whose hearing al- so significant improvement. Hearing improvement and facial nerve recovery were positively correlated （P 〈0.01）, especially for speech frequencies （p〈0.01）, Vertigo or dysequilibrium appeared to improve gradually along with improvement of facial palsy. Conclusion Ramsay-Hunt Syndrome should be differentiated from Bell＇s palsy. If taking a comprehensive drug treat- ment in time, patients are able to achieve good therapeutic effect. The significant improvement of Speech frequency in pa- tients with Ramsay-Hunt Syndrome is one good indicator that the function of facial nerve would recover better.