# Herpes Zoster Oticus: Systematic Review of Clinical Prognostic Factors

**Authors:** Arthur Justi Cassettari, Vagner Antônio Rodrigues Silva, Agrício Nubiato Crespo

PMC · DOI: 10.1055/s-0045-1810000 · 2026-03-11

## TL;DR

This paper reviews clinical factors affecting prognosis in Herpes Zoster Oticus, finding no definitive predictors due to inconsistent study methods.

## Contribution

A systematic review of clinical prognostic factors for Herpes Zoster Oticus, highlighting limitations in current research for reliable predictions.

## Key findings

- Clinical factors like age and treatment timing influence prognosis but lack definitive predictive power.
- Variations in study methods and definitions hinder reliable comparison and conclusive results.
- Current evidence does not support a single clinical parameter for predicting prognosis in RHS.

## Abstract

Herpes Zoster Oticus is etiologically associated with the reactivation of the Varicella-Zoster virus in the geniculate ganglion. Its primary manifestation includes pain, vesicles in the external auditory canal, and peripheral facial paralysis. The prognosis of the syndrome remains under scrutiny and debate, fluctuating based on symptom severity and clinical manifestation. The scarcity of articles accurately correlating clinical presentation and prognosis, coupled with individual factors and the syndrome's rarity, constrains more comprehensive analyses.

To conduct a systematic review to determine whether it is possible to predict the prognosis of RHS based on clinical factors.

This study identified a total of 6,464 articles within the databases, which were subsequently evaluated by two independent researchers. Sixty-two articles underwent full-text examinations, and following meticulous selection criteria, twelve articles were ultimately incorporated into this study. Factors such as age, onset of House-Brackmann degree, dizziness, hearing loss, time to treatment initiation, and comorbidities appear to exert influence on prognosis. The articles exhibit methodological limitations and discrepancies among them, stemming from variations in prognostic concepts, treatment protocols, evaluation timing, or reported outcomes. These variations hinder the possibility of conducting a methodologically sound comparison, regardless of how closely aligned the trials are with the theme.

The review concludes that it is not possible to definitively assert the presence of a clinical parameter defining the prognosis in Herpes Zoster Oticus.

## Linked entities

- **Diseases:** Herpes Zoster Oticus (MONDO:0005769)

## Full-text entities

- **Diseases:** dizziness (MESH:D004244), Herpes Zoster Oticus (MESH:D016697), pain (MESH:D010146), RHS (MESH:C535755), paralysis (MESH:D010243), hearing loss (MESH:D034381)
- **Species:** Human alphaherpesvirus 3 (Varicella-zoster virus, no rank) [taxon 10335]

## Figures

1 figure with captions in the complete paper: https://tomesphere.com/paper/PMC12978953/full.md

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Source: https://tomesphere.com/paper/PMC12978953