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Pharyngolaryngeal Involvement by Varicella-Zoster Virus.
MedLine Citation:
PMID:  23769009     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
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.
Authors:
Lluís Nisa; Basile Nicolas Landis; Roland Giger; Igor Leuchter
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-6-11
Journal Detail:
Title:  Journal of voice : official journal of the Voice Foundation     Volume:  -     ISSN:  1873-4588     ISO Abbreviation:  J Voice     Publication Date:  2013 Jun 
Date Detail:
Created Date:  2013-6-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8712262     Medline TA:  J Voice     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013 The Voice Foundation. Published by Mosby, Inc. All rights reserved.
Affiliation:
Department of Otorhinolaryngology-Head and Neck Surgery, Geneva University Hospitals, Geneva, Switzerland. Electronic address: llnisa@yahoo.ca.
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