Although facial nerve palsy is not a life-threatening disease, facial asymmetry affects interpersonal relationships, causes psychological stress, and devastates human life. The treatment and rehabilitation of facial paralysis has many socio-economic costs. Therefore, in cases of facial paralysis, it is necessary to identify the cause and provide the best treatment. However, until now, complete recovery has been difficult regardless of the treatment used in cases of complete paralysis of unknown cause and cutting injury of the facial nerve due to disease or accident. Therefore, this article aims to contribute to the future treatment of facial paralysis by reviewing studies on drugs that aid in nerve regeneration after peripheral nerve damage.

Ramsay Hunt syndrome (RHS) has a poor prognosis because of varicella-zoster virus (VZV) infection. This is most closely related to severe inflammation in the geniculate ganglion of the facial nerve due to VZV infection or reactivation. This study investigated whether there were differences in the prognosis and accompanying symptoms of facial paralysis based on the presence or absence of VZV IgM and IgG antibodies. This study was conducted as a retrospective chart analysis of 105 patients with RHS who were admitted to our hospital between 2015 and 2021. The House–Brackmann (HB) grade and electroneurography (ENoG) was used to evaluate the degree of facial paralysis. Patients’ subjective symptoms were evaluated by dividing them into dizziness, tinnitus, hyperacusis, and hearing loss. No difference was observed in the initial HB grade with or without IgM; however, the final HB grade was significantly higher in IgM-positive patients than in IgM-negative patients (p < 0.05). Further, when IgM was positive, the value of the orbicularis oculi muscle in the ENoG test results was significantly higher (p < 0.05), and symptoms of tinnitus and hyperacusis occurred more frequently (p < 0.05). The initial and final HB grades were significantly higher in IgG-positive patients than in IgG-negative patients (p < 0.05). When IgG was positive, the values of nasalis and oris muscles in the ENoG test results were significantly higher (p < 0.05), and symptoms of dizziness occurred more frequently (p < 0.05). This study confirmed that the more active the immunological action of the VZV in the body, the greater the damage to the facial and vestibulocochlear nerves, which are associated with the degree of facial paralysis and the accompanying otologic symptoms.

Background/Objectives: We used dizziness as a tracer condition to describe documented emergency-care changes during resident physician workforce disruption and return, and whether greater diagnostic intensity was accompanied by greater diagnostic yield. Methods: This single-center retrospective observational study compared two 13-month periods: no-resident (February 2024–February 2025) and resident-return (March 2025–March 2026). Registry data for all 1652 eligible emergency department (ED) dizziness visits provided primary treating department, an administrative department-of-record field, disposition, and length of stay. Detailed chart review was limited to patients with a formally documented otorhinolaryngology (ENT) consultation. Monthly staffing and on-call coverage came from duty rosters, and brain MRI reports were classified by clinical relevance. No causal inference was intended. Results: Dizziness represented a similar proportion of ED visits across periods (5.9% vs. 5.4%; rate ratio [RR], 0.91; p = 0.061). Formally documented ENT consultation increased from 26/667 (3.9%) to 186/985 (18.9%; RR, 4.84; p < 0.001), although ENT on-call coverage was recorded throughout and combined attending/fellow staffing declined from nine to six. Neurology department-of-record decreased from 24.7% to 13.0% and otolaryngology increased from 3.3% to 17.7% (both p < 0.001), while overall admission remained stable (24.1% vs. 23.9%; p = 0.896). Crude hospital length of stay decreased from 4.68 to 3.51 days (p = 0.002), but not after otolaryngology admissions were excluded (4.68 vs. 5.54 days; p = 0.208), indicating a case-mix effect. Among ENT-consulted patients, MRI utilization increased from 57.7% to 95.7% (p < 0.001); 1/192 classifiable studies showed an acute central lesion (0.5%) and 7 (3.6%) incidental lesions. Dizziness-specific revisits did not differ at 72 h or 30 days. Conclusions: Documented consultation, imaging, and administrative departmental attribution changed markedly, whereas dizziness burden, overall admission, and short-term revisits remained stable. Differential documentation plausibly explains a substantial part of the consultation difference, which measures documented rather than actual specialist involvement, and greater imaging intensity was not accompanied by greater acute diagnostic yield. These descriptive findings do not establish that care became better, safer, or more accurate.