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.

AJC: data curation, formal analysis, investigation, methodology, writing – original draft; VARS: conceptualization, formal analysis, methodology, supervision, validation, writing – review & editing; ANC: conceptualization, formal analysis, methodology, project administration, supervision, validation, Writing – review & editing.

Data supporting the results of this study are available upon a reasonable request from the corresponding author.

Data will be available upon request to the corresponding author.

Editor-in-Chief: Geraldo Pereira Jotz.

Received: 16 July 2024

Accepted: 24 May 2025

Article published online:
11 March 2026

© 2026. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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Bibliographical Record
Arthur Justi Cassettari, Vagner Antônio Rodrigues Silva, Agrício Nubiato Crespo. Herpes Zoster Oticus: Systematic Review of Clinical Prognostic Factors. Int Arch Otorhinolaryngol 2026; 30: s00451810000.
DOI: 10.1055/s-0045-1810000