Ramsay-Hunt syndrome complicating osteonecrosis of edentulous maxilla and mandible: report of a rare case

Abstract

Review of literature revealed atleast 30 cases of post herpes zoster osteonecrosis of maxilla or mandible. To our knowledge this is a first reported case of Ramsay-Hunt syndrome with post herpetic neuralgia and post herpes zoster osteonecrosis of edentulous maxilla and mandible. We have briefly reviewed the pathophysiology and management of post herpes zoster osteonecrosis and post herpetic neuralgia.

Post-traumatic near-complete aseptic necrosis of the maxilla: a case report and review of the literature

“…[5][6][7][8][9] Septic necrosis of the maxilla can be caused by fungal infections such as mucormycosis and aspergillosis. 5,6 Viral infections such as herpes zoster 7,8,15 affect immunocompromised patients, including those who have uncontrolled diabetes, lymphomas, organ transplants and long-term corticosteroid and immunosuppressive therapy. 5,6 Infections such as mucormycosis form thrombi within the blood vessels and result in decreased blood supply and necrosis.…”

Mandibular osteonecrosis following herpes zoster infection: Report of a rare case with a literature review

“…Herpes zoster infection (HZI) is caused by the reactivation of the VZV virus, 4 originally responsible for the primary infection of chicken pox, occurring usually in childhood. Then, the virus remains latent in the sensory nerve ganglia 5 and during some episode of trauma, immunosuppression (neoplasia, hematological pathology, HIV, diabetes, immunosuppressive treatment), or postradiotherapy, 1,4,5 it can reactivate with the appearance of a unilateral vesiculobullous skin rash in a metameric territory. The most commonly affected sites are the thoracic dermatomes (T3‐L3) in 56% of cases and the trigeminal ganglia in 18%‐22% of cases (most frequently ophthalmic branch) 3,4 .…”

“…Mandibular osteonecrosis is a well‐known phenomenon in oral pathology. It is due to a local ischemia and generally occurs in patients with a history of local irradiation (osteoradionecrosis), 1 anti‐osteoclastic treatments such as bisphosphonates, therapeutic monoclonal antibodies like denosumab and tocilizumab 2 (osteochimionecrosis), or chronic osteitis 1 …”

Mandibular Osteomyelitis As A Complication Of Ramsay Hunt Syndrome In An Elderly Patient

“…Very few case reports are available in the literature which have shown osteomyelitis of maxillary or mandibular arch associated with RHS. [3][4][5] A 69-year-old male patient's face was asymmetrical with hypopigmented patches, extending from temporal region to chin area and ruptured vesicles with crust formation, were seen on tragus of ear, forehead and scalp. Due to facial paralysis on the left side of the face, the patient was unable to close his left eye with obliterated nasolabial fold, absence of wrinkles on forehead, drooping left corner of the mouth and shift in the axis of the upper lip to the right.…”

“…If osteomyelitis is present, then antibiotics and antiviral therapy with aggressive debridement of necrotic bone can provide adequate wound and bone healing. Sonia Nath 1 , Jayant Prakash 2 , Narendra Nath Singh and Virendra Kumar Prajapati 4…”