Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2023, Vol. 37 ›› Issue (4): 68-74.doi: 10.6040/j.issn.1673-3770.0.2022.216

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Factors influencing the development of facial paralysis and the associated prognosis in patients with herpes zoster virus infection

FAN Tao1, ZHU Mengdie2, XIE Donghai1, LI Xiangsheng1, SONG Guilin1, XIAO Xuping3   

  1. 1.Department of Otolaryngology, Changsha Affiliated Hospital of Hunan Normal University/Changsha Fourth Hospital, Changsha 410006, Hunan, China2.Department of Otolaryngology, Ningxiang Hospital of Traditional Chinese Medicine, Changsha 410600, Hunan, China3. Department of Otolaryngology & Head and Neck Surgery, The First Affiliated Hospital of Hunan Normal University/Hunan Provincial People' s Hospital, Changsha 410005, Hunan, China
  • Published:2023-07-27

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Abstract: Objective The aim of this study was to analyze the influencing factors and predictors of adult facial herpes zoster virus infection complicated with facial paralysis, and to explore the risk factors affecting the prognosis of facial paralysis. Methods From January 2016 to April 2022, 125 patients with herpes zoster virus infections of the ear, who were admitted to the Otolaryngology Department of Changsha Affiliated Hospital of Hunan Normal University and Ningxiang Hospital of Traditional Chinese Medicine Hospital were retrospectively analyzed. Clinical data, routine blood parameters, and high-sensitivity C-reactive protein(hs-CRP)concentrations were compared between the facial paralysis and non-facial-paralysis groups. The predictive value of the receiver operating characteristic curve evaluation index for herpes zoster complicated with facial paralysis was determined. Based on the occurrence of facial paralysis sequelae, the patients were then divided into the sequelae and non-sequelae groups, and independent risk factors affecting their prognosis were analyzed. Results The hs-CRP concentration and lymphocyte-to-monocyte ratio(LMR)were independent influencing factors and had predictive value for herpes zoster virus infection complicated with facial paralysis. When the cut-off value of hs-CRP concentration was less than or equal to 3.05 mg/dL, the sensitivity was 50.77%, the specificity was 86.67%, the positive predictive rate was 80.49%, and the negative predictive rate was 61.9%. When the cut-off LMR value was greater than or equal to 2.89, the sensitivity was 44.44%, the specificity was 88.64%, the positive predictive rate was 87.8%, and the negative predictive rate was 46.43%. An age greater than 50 years, an initial degree of facial paralysis greater than grade III, more than 72 hours from facial paralysis to hormone therapy, and no antiviral treatment before facial paralysis were independent risk factors for facial paralysis sequelae in patients with herpes zoster virus infections. Conclusion hs-CRP concentration and LMR have a certain reference value in predicting whether herpes zoster virus infections of the ear will be complicated with facial paralysis. The use of antiviral drugs before the onset of facial paralysis may reduce the irreversible sequelae.

Key words: Facial paralysis, Ramsay-Hunt syndrome, Varicella-zoster virus, Herpes zoster oticus, Periauricular pain

CLC Number: 

  • R764.1
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