A 24-year-old man presents with left facial palsy and clusters of vesicles in the concha and posterior wall of the external auditory canal. The cutaneous vesicles are explained by involvement of which nerve?

• A Auricular branch of the vagus nerve ✓
• B Auriculotemporal nerve
• C Great auricular nerve
• D Lesser occipital nerve

Explanation

This is herpes zoster oticus (Ramsay Hunt syndrome). The vesicles appear in the territory of the auricular branch of the vagus (Arnold nerve), which supplies the concha, posteroinferior meatal wall and a small area behind the ear. Herpes zoster of the geniculate ganglion spreads to this cutaneous branch, producing vesicles alongside facial palsy. The great auricular and lesser occipital nerves supply neck and postauricular skin but are not related to the geniculate ganglion.

Reference: Cummings Otolaryngology Head and Neck Surgery, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.