Pharyngolaryngeal involvement by varicella-zoster virus

Nisa, Lluís; Landis, Basile Nicolas; Giger, Roland; Leuchter, Igor (2013). Pharyngolaryngeal involvement by varicella-zoster virus. Journal of voice, 27(5), pp. 636-641. Mosby 10.1016/j.jvoice.2013.02.011

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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.

Item Type:	Journal Article (Original Article)
Division/Institute:	04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Ear, Nose and Throat Disorders (ENT)
UniBE Contributor:	Landis, Basile Nicolas, Giger, Roland
Subjects:	600 Technology > 610 Medicine & health
ISSN:	0892-1997
Publisher:	Mosby
Language:	English
Submitter:	Lilian Tschan
Date Deposited:	07 Mar 2014 09:31
Last Modified:	05 Dec 2022 14:29
Publisher DOI:	10.1016/j.jvoice.2013.02.011
PubMed ID:	23769009
Uncontrolled Keywords:	Cranial polyneuropathy, Deglutition disorders, Glossopharyngeal nerve, Speech disorders, Vagus nerve, Varicella-zoster virus
URI:	https://boris.unibe.ch/id/eprint/43446