Introduction Ramsay Hunt syndrome is the second most common cause of facial palsy. Early and correct treatment should be performed to avoid complications, such as permanent facial nerve dysfunction. Objective The objective of this study is to review the prognosis of the facial palsy on Ramsay Hunt syndrome, considering the different treatments proposed in the literature. Data Synthesis We read the abstract of 78 studies; we selected 31 studies and read them in full. We selected 19 studies for appraisal. Among the 882 selected patients, 621 (70.4%) achieved a House-Brackmann score of I or II; 68% of the patients treated only with steroids achieved HB I or II, versus 70.5% when treated with steroids plus antiviral agents. Among patients with complete facial palsy (grades V or VI), 51.4% recovered to grades I or II. The rate of complete recovery varied considering the steroid associated with acyclovir: 81.3% for methylprednisolone, 69.2% for prednisone; 61.4% for prednisolone; and 76.3% for hydrocortisone. Conclusions Patients with Ramsay-hunt syndrome, when early diagnosed and treated, achieve high rates of complete recovery. The association of steroids and acyclovir is better than steroids used in monotherapy.

The objective of this study is to review the literature regarding Auditory Brainstem Implant (ABI) indications, surgical techniques, activation methods, and post-surgery follow-up in children. A search was performed in the LILACS, MEDLINE, SciELO, and PubMed databases in June 2014, and the key words used in the search were (("auditory brain stem implant" OR "auditory brainstem implants") OR ("auditory" AND "brainstem" AND ("implants" OR "implant")). Forty-two studies that met the criteria described in "Study Selection" were read in full; 24 studies referred to the ABI fitting process in children, and were selected for appraisal. The studies showed 120 children (younger than 18 years old) fitted with ABIs. Evaluation after surgery showed that 112 (93.3%) of the patients improved in their ability to recognize environmental sounds and speech perception. Patients with tumors or those with cochlear or cochlear nerve malformations had good outcomes as well. Two of the children did not achieve any sound perception upon ABI activation. The results obtained in 120 children fitted with an ABI showed that the patients globally improved in their ability to detect sounds and communication skills. The phenomenon could be seen both in patients with tumoral diseases of the inner ear and those with malformations of the cochlea or cochlear nerve, although patients with non-tumoral issues achieved better results than patients with schwannomas. We propose that the Food and Drug Administration (FDA) ABI indications should be extended to patients younger than 12 years old with NT diseases of the cochlea and cochlear nerve.

Objectives: Review the literature regarding auditory brainstem implant (ABI) indications, surgical techniques, activation methods, and postsurgery follow-up in children. Methods: A search was performed in LILACS, MEDLINE, SciELO, and PubMed databases from January to March 2013, and the key words used in the search were brainstem AND implant OR implantation AND children OR child. Studies that referred to results of the ABI fitting process in children were selected. Results: Seventy-two studies that met the criteria were read in full; 17 studies referred to the ABI fitting process in children and were selected for appraisal. The studies showed the cases of 49 children (younger than 18 years old) fitted with ABIs. Evaluation after surgery showed that 47 (95.9%) of the patients improved in their ability to recognize environmental sounds and speech perception. Patients with tumors or those with cochlear or cochlear nerve malformations had good outcomes as well. Two of the children achieved no sound perception upon ABI activation. Conclusions: The US Food and Drug Administration (FDA) only approves the auditory brainstem implant for children older than 12 years old, but good outcomes in children younger than that age were achieved, improving environmental sound awareness and oral language development. The FDA only recently approved clinical trials for patients younger than 12 years old. We propose that the FDA auditory brainstem implant indications should be extended to patients with nontumoral diseases of the cochlea and cochlear nerve and younger than 12 years old.

Objectives: Review the prognosis of facial palsy on Ramsay Hunt syndrome after the treatments proposed by different authors, based on a review of the literature. Methods: A search was performed in LILACS, SciELO, and PUBMED databases. The key words used on the search were: prognosis OR evolution AND ramsay-hunt OR herpes zoster oticus AND facial palsy OR facial paralysis. Results: Studies showed 882 patients with facial palsy secondary to Ramsay Hunt syndrome. Six hundred and twenty one (70.4%) of those patients achieved improvement on the House-Brackmann grade, achieving a grade score of I or II. Among the patients treated only with steroids, 68% got the same results, versus 70.5% of the patients treated with steroids plus antiviral agents. Of patients classified on the House-Brackmann grade as V or VI before treatment, 51.4% improved facial nerve function, achieving I or II on the HB scale. The treatment with methylprednisolone associated with acyclovir showed better results when compared with acyclovir associated with prednisone, prednisolone or hydrocortisone (81.3% versus 69.2%, 61.4% and 76.3%, respectively). Conclusions: Patients with Ramsay Hunt syndrome may achieve a good rate of facial recovery. The steroid associated with better results was methylprednisolone, and the association of steroids and acyclovir achieved better results than the patients who did not receive the antiviral agent.

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