Prognostic correlation among facial nerve palsy, hearing impairment, and vestibular disorder in Ramsay Hunt syndrome

Sixteen cases of Ramsay Hunt syndrome were investigated concerning the prognosis of facial nerve palsy, hearing impairment, and vestibular disorder. The satisfactory prognosis of facial nerve palsy was achieved in those cases which a good response was evoked by the maximal stimulation test as well as in cases of Bell's palsy. And also, the satisfactory prognosis of hearing impairment was achieved in those cases which showed a well-developed auditory whole nerve action potential and a well-developed cochlear microphonics the electrocochleography as well as in cases of sudden deafness. On the contrary, both facial nerve palsy and hearing impairment showed unsatisfactory prognosis in those cases which there was a low amplitude or even no response. Thus, satisfactory prognosis was achieved in those cases which showed well-developed responses induced by an intensive stimulation. This phenomenon is suggestive of the pathophysiology of reversible impairment of sensorineural elements. However, no correlation among the prognosis of facial nerve palsy, hearing impairment, or vestibular disorder was observed.