Retrospective Study of Associated Laryngeal Paralysis Thought to Be Due to Reactivation of Varicella Zoster Virus or Herpes Simplex Virus

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  • Suzumasa Takashi
    Department of Otolaryngology-Head and Neck Surgery, National Defense Medical College Hospital
  • Inuzuka Yoshiaki
    Department of Otolaryngology-Head and Neck Surgery, National Defense Medical College Hospital
  • Tomifuji Masayuki
    Department of Otolaryngology-Head and Neck Surgery, National Defense Medical College Hospital Musashisakai E.N.T. Clinic
  • Araki Koji
    Department of Otolaryngology-Head and Neck Surgery, National Defense Medical College Hospital
  • Segoe Kenta
    Department of Otolaryngology-Head and Neck Surgery, National Defense Medical College Hospital
  • Inuzuka Eri
    Department of Otolaryngology-Head and Neck Surgery, National Defense Medical College Hospital
  • Takihata Saki
    Department of Otolaryngology-Head and Neck Surgery, Nishisaitama-chuo National Hospital
  • Uno Kousuke
    Department of Otolaryngology-Head and Neck Surgery, National Defense Medical College Hospital
  • Mizutari Kunio
    Department of Otolaryngology-Head and Neck Surgery, National Defense Medical College Hospital
  • Shiotani Akihiro
    Department of Otolaryngology-Head and Neck Surgery, National Defense Medical College Hospital

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Other Title
  • 水痘帯状疱疹ウイルスもしくは単純ヘルペスウイルスの再活性化によると考えられた混合性喉頭麻痺症例の検討
  • スイトウ タイジョウホウシンウイルス モシクワ タンジュンヘルペスウイルス ノ サイカッセイカ ニ ヨル ト カンガエラレタ コンゴウセイ コウトウ マヒ ショウレイ ノ ケントウ

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Abstract

<p>Laryngeal paralysis is occasionally associated with other cranial neuropathies. Associated laryngeal paralysis, as the disease is then called, is thought to be caused by viral infections and is often difficult to diagnose in its early stages. In this study, we reviewed 6 cases of associated laryngeal paralysis believed to be due to reactivation of varicella zoster virus (VZV) or herpes simplex virus (HSV) which we observed between November 2013 and October 2019. Our review showed that dysphagia was present in all 6 cases, facial nerve paralysis in 5 cases, curtain signs in 3 cases, and vestibulocochlear dysfunction such as hearing loss in 4 cases. One case was clinically diagnosed with Ramsay Hunt syndrome, 4 cases were diagnosed with viral reactivation by VZV, and 1 case was diagnosed with idiopathic or viral reactivation by HSV. All patients were treated with corticosteroid and anti-viral therapy. After treatment, the laryngeal paralysis improved in 5 of the 6 cases. Dysphagia, facial nerve paralysis and vestibulocochlear dysfunction improved in all cases. Early diagnosis of viral-associated laryngeal paralysis is difficult when it lacks any of the three characteristics of Ramsay Hunt syndrome : skin rash, facial nerve palsy, and inner ear nerve palsy. At the same time, laryngeal paralysis has a poor prognosis. For these reasons, early therapeutic intervention is needed and otolaryngologists should perform early treatment for patients with associated laryngeal paralysis thought to be due to reactivation of VZV or HSV, in order to improve their prognosis.</p>

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