A patient complains of pain behind the ear following herpes zoster reactivation and is found to have ipsilateral facial palsy, vesicles in the external auditory meatus, and tinnitus. What is the anatomical basis of the auricular vesicles in this condition?

• A Greater auricular nerve (C2, C3) reactivation
• B Auriculotemporal nerve (V3) distribution
• C Lesser occipital nerve (C2) reactivation
• D Sensory branch of CN VII (nervus intermedius) supplying the concha ✓

Explanation

This is Ramsay Hunt syndrome (herpes zoster oticus). The facial nerve carries general somatic afferent fibers via the nervus intermedius that supply the skin of the auricle, external auditory meatus, and retroauricular area. When the geniculate ganglion is affected by VZV reactivation, these sensory fibers produce vesicles in that distribution. The motor fibers of CN VII are also damaged at the geniculate ganglion, causing lower motor neuron facial palsy.

Reference: BD Chaurasia's Human Anatomy, 8th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.