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ENT · Facial nerve: Ramsay Hunt syndrome
Sample itemA man has severe ear pain, vesicles in the concha and external canal, facial palsy and sensorineural hearing loss. Which structure is primarily involved by the virus?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
D. Geniculate ganglion
Ramsay Hunt syndrome type 2 is reactivation of varicella zoster virus in the geniculate ganglion. Treatment is oral acyclovir (or valacyclovir) with prednisolone. Prognosis is worse than in Bell's palsy.
Option by option
A. Spiral ganglion
The spiral ganglion is in the cochlea and is not the primary site.
B. Gasserian ganglion
The Gasserian ganglion is the trigeminal ganglion.
C. Stellate ganglion
The stellate ganglion is a sympathetic ganglion.
D. Geniculate ganglion (correct)
Correct. VZV reactivates in the geniculate ganglion.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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