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DOI

http://dx.doi.org/10.18590/mjm.2016.vol2.iss2.5

Abstract

Gradenigo syndrome is a very rare complication of otitis media that if left unrecognized and subsequently untreated will result in severe neurologic sequelae. Gradenigo Syndrome clinically represented by the triad of otitis media, ipsilateral, abducens nerve palsy and dysasthesia within the V1 and V2 divisions of the trigeminal nerve branches. We describe a 4 year-old patient who presented with headache, facial pain, diplopia and a recent history of upper respiratory tract symptomatology. Examination revealed an abducens palsy with subsequent magnetic resonance imaging demonstrating inflammation in the left petrous apex and along the tracts of the 6th, 7th, and 8th cranial nerves. The patient was treated with antibiotics along with myringotomy and had complete resolution of his symptoms.

Conflict(s) of Interest

N/A

References with DOI

1. Gradenigo G: Uber die paralyse des n. Abduzens bei otitis. Arch F Ohrenheilk. 1907;74:149-158. http://dx.doi.org/10.1007/bf01930369

2. Jacobsen CL, Bruhn MA, Yavarian Y, Gaihede ML. Mastoiditis and Gradenigo's Syndrome with anaerobic bacteria. BMC Ear Nose Throat Disord. 2012;14:12:10. http://dx.doi.org/10.1186/1472-6815-12-10

3. Gradenigo syndrome and petrositis in a child. Favier M, Bessou P, Franco-Vidal V, Pédespan JM. Arc h Pediatr. 2015 Mar;22(3):283-6.

4. Marianowski R, Rocton S, Ait-Amer JL, Morisseau- Durand MP, Manach Y. Conservative management of Gradenigo syndrome in a child. Int J Pediatr Otorhinolaryngol. 2001;57(1):79-83. http://dx.doi.org/10.1016/s0165-5876(00)00442-0

5. Jackler RK, Parker DA. Radiographic differential diagnosis of petrous apex lesions. Am J Otol. 1992;13(6):561-74.

6. Kantas I, Papadopoulou A, Balatsouras DG, Aspris A, Marangos N. Therapeutic approach to Gradenigo's syndrome: a case report. J Med Case Rep. 2010;24:4:151. http://dx.doi.org/10.1186/1752-1947-4-151

7. Minotti AM, Kountakis SE. Management of abducens palsy in patients with petrositis. Ann Otol Rhinol Laryngol. 1999; 108(9):897-902. http://dx.doi.org/10.1177/000348949910800914

8. Kong SK, Lee IW, Goh EK, Park SE. Acute otitis media-induced petrous apicitis presenting as the Gradenigo syndrome: successfully treated by ventilation tube insertion. Am J Otolaryngol. 2011;32(5):445-7. http://dx.doi.org/10.1016/j.amjoto.2010.07.018

9. Mystery Case: Cholesterol granuloma of the petrous apex in Gradenigo syndrome. Lattanzi S, Cagnetti C, Di Bella P, Provinciali L.Neurology. 2015 A pr 28;84(17):e122-3.

10. Favier M, Bessou P, Franco-Vidal V, Pédespan JM. Gradenigo syndrome and petrositis in a child. Arch Pediatr. 2015 Mar;22(3):283-6.

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