Herpes Zoster Oticus: A Morbid Clinical Entity

The reactivation of varicella zoster virus (VZV) at the geniculate ganglion of the facial nerve results in herpes zoster virus. Patients of herpes zoster oticus (HZO) often present with symptoms related to the cochleovestibular dysfunction along with otalgia and vesicular eruption at the pinna and external auditory canal. Patients of HZO usually present with hearing loss, vertigo, and facial nerve paralysis. When it is associated with facial nerve paralysis, HZO is called Ramsay Hunt syndrome (RHS). In the majority of cases, patients with vertigo have hearing loss, whereas patients without hearing loss have no vertigo. It is a self-limiting viral disease and the morbidity is often caused due to facial nerve paralysis. If HZO is not diagnosed immediately and treated timely often it progress to RHS. Clinician education is vital for detecting the HZO/RHS at an early stage so that facial nerve paralysis can be prevented along with associated morbidity. In this review article, we discuss the current concept and recent advances in the etiopathology, diagnosis, and treatment of HZO.