Herpes Zoster Oticus Park SY A B C Fig. 1. Variable extent of auricular vesicular eruptions of three different cases of typical Ramsay Hunt syndrome.

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1 online ML Comm Clinical Review Korean J Otorhinolaryngol-Head Neck Surg 2014;57:78-83 / pissn / eissn Herpes Zoster Oticus Sang Yoo Park Department of Otolaryngology-Head and Neck Surgery, Yonsei University Wonju College of Medicine, Wonju, Korea 이성대상포진 박상유 연세대학교원주의과대학이비인후과학교실 Received March 26, 2013 Accepted June 18, 2013 Address for correspondence Sang Yoo Park, MD, PhD Department of Otolaryngology- Head and Neck Surgery, Yonsei University Wonju College of Medicine, 20 Ilsan-ro, Wonju , Korea Tel Fax sangyoo3@yonsei.ac.kr Herpes zoster oticus, traditionally known as Ramsay Hunt syndrome, is nowadays described also as acute peripheral facial neuropathy by varicella zoster virus infection. Besides facial palsy, auricular vesicular eruptions accompanied by neuralgic pain, adjacent cranial nerve structures are involved and various audiovestibular symptoms are frequently combined. Early proper treatment strategies are required to get the favorable outcome and reduce the morbidity of neurocranial deficits of this syndrome. Korean J Otorhinolaryngol-Head Neck Surg 2014;57:78-83 Key WordsZZHerpes zoster oticus ㆍ Ramsay Hunt syndrome. 서론 Copyright 2014 Korean Society of Otorhinolaryngology-Head and Neck Surgery

Herpes Zoster Oticus Park SY A B C Fig. 1.

2 Herpes Zoster Oticus Park SY A B C Fig. 1. Variable extent of auricular vesicular eruptions of three different cases of typical Ramsay Hunt syndrome. Localized to cymba concha (A). Appeared all over the auricle (B). Massive spread into face (C). 임상증상의다양성 79

3 Korean J Otorhinolaryngol-Head Neck Surg 2014;57:78-83 청각및전정신경의증상 - - 소아기의이성대상포진 진단 in situ 80

Herpes Zoster Oticus Park SY 치료 - A Fig. 2. 33-year-old female patient with Rt Ramsay Hunt syndrome.

labyrinthine segment of Rt facial nerve enhanced abnormally, and its ganglion and proximal tympanic

4 Herpes Zoster Oticus Park SY 치료 - A Fig year-old female patient with Rt Ramsay Hunt syndrome. On the gadolinium enhanced T1 weighted axial and coronal images, the intracanalicular and labyrinthine segment of Rt facial nerve enhanced abnormally, and its ganglion and proximal tympanic segment enhanced asymmetrically compared to the opposite side. Axial image (A). Coronal image (B). B 81

5 Korean J Otorhinolaryngol-Head Neck Surg 2014;57:78-83 예후 결 론 REFERENCES 1) Körner O. Über den Herpes zoster oticus. Munch Med Wochenschr 1904;1: ) Hunt JR. On herpetic inflammations of the geniculate ganglion: a new syndrome and its complications. J Nerv Ment Dis 1907;34: ) Hunt JR. The sensory system of the facial nerve and its symptomatology. J Nerv Ment Dis 1909;36: ) Hunt JR. The symptom-complex of the acute posterior poliomyelitis of the geniculate, auditory, glossopharyngeal and pneumogastric ganglia. Arch Intern Med 1910;5: ) Hunt JR. The role of the carotid arteries in the causation of vascular lesions of the brain, with remarks on certain special features of the symptomatology. Am J Med Sci 1914;147: ) Hunt JR. Dyssynergia cerebellaris progressiva: a chronic progressive form of cerebellar tremor. Brain 1914;37(2): ) Burke BL, Steele RW, Beard OW, Wood JS, Cain TD, Marmer DJ. Immune responses to varicella-zoster in the aged. Arch Intern Med 1982;142(2): ) Ikeda M, Hiroshige K, Abiko Y, Onoda K. Impaired specific cellular immunity to the varicella-zoster virus in patients with herpes zoster oticus. J Laryngol Otol 1996;110(10): ) Hu S, Walker M, Czartoski T, Cheng A, Forghani B, Gilden DH, et al. Acyclovir responsive brain stem disease after the Ramsay Hunt syndrome. J Neurol Sci 2004;217(1): ) Alicandri-Ciufelli M, Aggazzotti-Cavazza E, Genovese E, Monzani D, Presutti L. Herpes zoster oticus: a clinical model for a transynaptic, reflex pathways, viral transmission hypotheses. Neurosci Res 2012; 74(1): ) Gilden D, Cohrs RJ, Mahalingam R, Nagel MA. Varicella zoster virus vasculopathies: diverse clinical manifestations, laboratory features, pathogenesis, and treatment. Lancet Neurol 2009;8(8): ) Aviel A, Marshak G. Ramsay Hunt syndrome: a cranial polyneuropathy. Am J Otolaryngol 1982;3(1):

6 Herpes Zoster Oticus Park SY 13) Kim YH, Chang MY, Jung HH, Park YS, Lee SH, Lee JH, et al. Prognosis of Ramsay Hunt syndrome presenting as cranial polyneuropathy. Laryngoscope 2010;120(11): ) Shim HJ, Jung H, Park DC, Lee JH, Yeo SG. Ramsay Hunt syndrome with multicranial nerve involvement. Acta Otolaryngol 2011;131(2): ) Kin T, Hirano M, Tonomura Y, Ueno S. Coexistence of Ramsay Hunt syndrome and varicella-zoster virus encephalitis. Infection 2006; 34(6): ) Oh JH, Lee HH, Kim MJ. A case of Ramsay Hunt Syndrome complicated with multiple cranial nerve palsy followed by a brain stem lesion. Korean J Otorhinolaryngol-Head Neck Surg 2012;55 (10): ) Kim JB, Byun JY, Kim SW, Cha CI. Two cases of Ramsay Hunt Syndrome complicated with multiple cranial nerve palsy and aseptic meningitis. Korean J Otolaryngol-Head Neck Surg 2005;48(3): ) Boo SH, Bok KH, Ryu NG, Chung WH. A case of herpes zoster oticus involving vestibular nerve without facial nerve palsy. 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Correlation between enhanced MRI and surgical findings in herpes zoster oticus. Acta Otolaryngol 2009;129(8): ) Uscategui T, Dorée C, Chamberlain IJ, Burton MJ. Antiviral therapy for Ramsay Hunt syndrome (herpes zoster oticus with facial palsy) in adults. Cochrane Database Syst Rev 2008;(4):CD ) Uscategui T, Doree C, Chamberlain IJ, Burton MJ. Corticosteroids as adjuvant to antiviral treatment in Ramsay Hunt syndrome (herpes zoster oticus with facial palsy) in adults. Cochrane Database Syst Rev 2008;(3):CD ) de Ru JA, van Benthem PP. Combination therapy is preferable for patients with Ramsay Hunt syndrome. Otol Neurotol 2011;32(5): ) Murakami S, Hato N, Horiuchi J, Honda N, Gyo K, Yanagihara N. Treatment of Ramsay Hunt syndrome with acyclovir-prednisone: significance of early diagnosis and treatment. Ann Neurol 1997;41 (3): ) Bai CH, Lee SC, Choi YH, Chen SM, Baek UH, Jung EC, et al. A study for the effect of stellate ganglion block on herpes zoster oticus. 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386-390.hwp 386 HANYANG MEDICAL REVIEWS Vol. 29 No. 4, 2009 우리나라 미숙아의 통계와 의료비용 Statistics and Medical Cost of Preterm in Korea 윤혜선 을지대학교 노원을지병원 소아청소년과학교실 Hye Sun Yoon, M.D., Ph.D., Department of Pediatrics, Nowon