How is herpes zoster oticus treated?

Speaking of herpes zoster oticus, I believe everyone is confused. Simply put, it is herpes that grows in the ear, usually caused by decreased immunity. If not treated in time, it may turn into facial paralysis, which is very annoying. People with diabetes, cancer, chemotherapy, and those over 70 years old are most likely to develop the disease. So how should herpes zoster oticus be treated?

01Symptoms

Symptoms

1) Prodromal symptoms: general discomfort, low fever, headache, loss of appetite, etc.

2) Earache and neuralgia: First, there is severe pain in the auricle, ear canal and behind the ear, burning pain, sometimes like trigeminal neuralgia, but without trigger points. It may radiate to the pharynx and face. Nerve pain can last for months or even years.

3) Herpes: Herpes appears on the auricle (especially the concha cavity), ear canal opening, ear canal and skin behind the ear, followed by local skin congestion, swelling, erosion and blisters. Most herpes outbreaks are preceded by facial paralysis. The pustules form crusts that fall off in about 2-3 weeks. The location where herpes appears is related to the distribution of afferent nerve fibers. It can appear along the distribution of the facial nerve sensory nerve fibers in the auricle and ear canal, or in the fiber distribution area of ​​the V, IX, and X cranial nerves or the branches of the cervical nerves. Therefore, herpes can appear in the oral cavity, buccal mucosa, soft palate, tonsils, root of the tongue, throat, and neck. Accompanied by pain in these areas.

4) Facial paralysis: The incidence of facial paralysis in herpes zoster oticus is 4.5-9% (also reported as 3-9%). Severe facial paralysis. The disease may initially present as partial facial nerve paralysis, which may rapidly develop into complete facial paralysis within a few days or 2-3 weeks. The peak period is 10-14 days.

5) Symptoms of hearing loss: generally mild to moderate sensorineural hearing loss. Accompanied by tinnitus and hearing sensitivity.

6) Symptoms of impaired vestibular function: mild to moderate vertigo, balance disorders, and feeling of unsteadiness when walking. In 25% of patients, vestibular symptoms occur before facial paralysis. Nystagmus may occur.

7) Other symptoms of cranial nerve involvement: Patients with combined cranial nerve symptoms are more common than those with Bell's palsy. Accompanied by symptoms of the Vth, VI, IX, Xth, XI, and XII cranial nerves. If the ophthalmic branch of the trigeminal nerve is affected (about 10-15% of patients), uveitis, keratoconjunctivitis, optic neuritis, and glaucoma may occur. Decreased or absent superficial and deep sensation. In addition to facial paralysis, facial nerve involvement can also cause symptoms such as decreased tears, decreased salivation, loss of taste, and nasal congestion. If the Xth cranial nerve is affected, hoarseness and soft palate paralysis may occur.

02Treatment

Currently, the disease is mainly treated with drug therapy. Glucocorticoid drugs are usually the main therapeutic drugs for the disease in clinical practice. These drugs can reduce the inflammatory response and swelling of the facial nerve, reduce the pressure in the facial nerve bone canal with a fixed diameter, and thus reduce the compression of the facial nerve by the facial nerve bone canal due to edema and thickening.

Patients can also combine treatment with antiviral drugs, which can effectively control the replication of local viruses, promote the scabbing and shedding of herpes, and promote the healing of local lesions. Common drugs include: ganciclovir, famciclovir or valacyclovir.

Patients are advised to get as much rest as possible in their daily lives, keep their bodies hydrated, pay attention to local cleanliness and hygiene, and prevent bacterial infections. You can also apply Chinese herbal medicine or Levnol wet compress externally to promote the drying and scabbing of blisters. Elderly patients with severe cases, especially those with herpes zoster on the head and face, are best hospitalized to prevent complications.

03Precautions

Patients are advised to maintain a good attitude in their daily lives and avoid excessive mental stress and anger. In addition, they should lead a regular life, strengthen exercise, limit tobacco, alcohol and irritating foods (peppers, raw onions, raw garlic, etc.), and eat more fresh vegetables and fruits.