What is herpes zoster oticus?

Updated: Feb 11, 2021
  • Author: Camila K Janniger, MD; Chief Editor: Dirk M Elston, MD  more...
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Herpes zoster oticus (also termed geniculate zoster, zoster auris, Ramsay Hunt syndrome, or Hunt syndrome) may develop if the geniculate ganglion is involved. This condition is considered rare but more likely is just rarely recognized. It often is mistaken for eczema, Ménière disease, Bell palsy, stroke, and abscess of the ear.

Classically, herpes zoster oticus begins with otalgia and herpetiform vesicles in the external ear canal or on the tympanic membrane, with or without features of facial paralysis resulting from facial nerve (CN VII) involvement, auditory symptoms (eg, deafness), and vestibular symptoms in variable combinations. The syndrome also may result from zoster originating from CN IX or CN X; the external ear has complex innervation that includes branches of several CNs (CN V, CN VII, CN IX, and CN X), as well as vertebral nerve C2 and possibly C3.

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