Akio Suzuki

Herpes Zoster with Oral Mucosa Symptom at the First Finding; A Case Report

A 61-year-old male visited our development because of a piercing sensation on his tongue. At the first examination, a fur (about 1 x 1 cm) on the right buccal mucosa revealed few findings. Four days later, however, the patient developed a papule on the right side of his face and an ulcer on the right half of the tongue. For this reason, he was admitted to our department. After admission, drip infusion of vitamin B and aciclovir therapy were administered. Although the initial symptoms disappeared in about 2 weeks, right facial palsy subsequently developed. Therefore, massive steroid therapy was initiated. About 2 months after admission, the right facial palsy was almost completely gone, and the patient was discharged. Hunt syndrome is a herpes zoster virus infection known in the field of otorhinolaryngology. Occasionally, patients with this syndrome develop multiple cranial nerve injury. In the present case, the initial sign was discomfort in the oral mucosa. The patient later developed a papule on the right side of his face and an ulcer on the right half of the tongue, followed by right facial palsy. Based on these sympoms, this case was diagnosed as herpes zoster, accompanied by injury of the V th, VlIth and lXth cranial nerves. The mode and route of the spread of herpes zoster infection are discussed.

A case report of masseteric hypertrophy.

A 25-year-old man with masseteric hypertrophy is reported. He was operated on by the external approach according to modified Gurneys method.CT scan was very useful for diagnosing this case. Pathologic examination of the hypertrophied masseter showed normal striated muscle tissue.Surgical correction of the appearance should be performed if the patient desires esthetic repair. The extraoral approach is recommended because it is easier than the intraoral approach. The cause of masseteric hypertrophy still remains obscure, postoperative care is necessary for a long time.