Summary
Introduction
Involvement of cranial nerves V, VII, and VIII by varicella-zoster virus (VZV) is
widely reported in the literature, whereas involvement of cranial nerves IX and X
is rarer and therefore poorly characterized.
Material and Methods
We performed a systematic review of the literature through MEDLINE (up to January
2012). We selected cases reporting pharyngolaryngeal involvement by VZV and extracted
clinical features, complementary studies, treatments, and outcome. We added three
cases to the existing literature.
Results
Of the 65 screened articles, 38 were included reporting 54 cases. The main clinical
features were odynodysphagia and dysphonia reflecting underlying hemipharyngolaryngeal
palsy. Vesicles were seen in 66% of the patients. Besides the involvement of cranial
nerves IX and X, concomitant involvement of other cranial nerves was seen in 48% of
the cases. The most concerned nerves were cranial nerves VII and VIII. Virological
tests (63%) and imaging (28%) were performed, with the latter being systematically
normal. Seventy-two percent of patients were treated with antiviral agents and/or
corticosteroids. Twenty-six percent of patients made a full recovery while the remaining
had some persistent deficits. We did not find statistically significant differences
in outcomes according to age or treatments received.
Conclusions
Pharyngolaryngeal involvement by VZV is rare and seldom restricted to the ninth and
tenth cranial nerves. It occurs mostly within the context of cranial polyneuropathy.
Regardless of the treatment, full recovery is rare and long-term sequelae persist
in many cases, especially with speech and swallowing impairment. Close monitoring
and follow-up are therefore essential.
Key Words
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Article info
Publication history
Published online: June 13, 2013
Accepted:
February 26,
2013
Footnotes
B.N.L. is a consultant for smell and taste disorders at Geneva University Hospitals.
Identification
Copyright
© 2013 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
