Denouement and Discussion
Geniculate Ganglion Syndrome
(Hunt's Syndrome, Herpes Zoster Oticus)
Herpes zoster virus produces a vesicular eruption of the external ear and the external auditory canal and may or may not involve the oral mucosa, tongue, and peritonsillar region. Inflammation of the sensory or geniculate ganglion of the facial nerve causes a seventh nerve palsy. There is a burning, boring, severe pain usually located in the ear canal and pinna although this is not a constant feature. Deafness, tinnitus, vertigo, facial sensory loss, nystagmus, hoarseness, dysphagia, and decreased lacrimation may result from involvement of the eighth, ninth, and tenth cranial nerves.
Steroid treatment may shorten the course of the disorder. Analgesics are often necessary. Recovery from the cutaneous manifestations is usually complete but return of cochlear and vestibular function is less predictable.