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Gradenigo's syndrome in a four-year-old patient: a rare diagnosis in the modern antibiotic era

Published online by Cambridge University Press:  28 May 2019

N Rossi ,
M L Swonke ,
L Reichert  and
D Young
N Rossi*
Affiliation:
School of Medicine, University of Texas Medical Branch, Galveston, USA
M L Swonke
Affiliation:
School of Medicine, University of Texas Medical Branch, Galveston, USA
L Reichert
Affiliation:
Department of Otolaryngology, University of Texas Medical Branch, Galveston, USA
D Young
Affiliation:
Department of Otolaryngology, University of Texas Medical Branch, Galveston, USA
*
Author for correspondence: Dr Nicholas Rossi, 8817 Echo Valley Drive, Houston, TX 77055, USA E-mail: Nicholas.armando.rossi@gmail.com Fax: +1 713 465 0124
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Abstract

Objective

This study gives details of a rare case of petrous apicitis that presented as Gradenigo's syndrome and was managed surgically.

Method

This study presents a case report and review of the literature.

Results

A four-year-old female was admitted for failure to thrive following recent sinusitis. Physical examination was positive for right sided facial pain, photophobia and right abducens nerve palsy. Subsequent magnetic resonance imaging revealed a 1.3 × 1.7 × 1.4 cm abscess encompassing the right Meckel's cave. A computed tomography scan showed petrous apicitis and otomastoiditis, confirming Gradenigo's syndrome. The patient was taken to the operating theatre for right intact canal wall mastoidectomy with myringotomy and tube placement. She was discharged on six weeks of ceftriaxone administered by a peripherally inserted central catheter line. At a two-week post-operative visit, she showed notable improvement in neuropathic symptoms.

Conclusion

This study presents a rare case of petrous apicitis managed surgically without the need for a craniotomy or transcochlear procedure.

Keywords

Abducens NerveVestibulocochlear NerveTrigeminal NerveMastoiditisPetrositisMastoidectomyAbducens Nerve DiseasesTemporal Bone

Information

Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 133 , Issue 6 , June 2019 , pp. 535 - 537
Copyright
Copyright © JLO (1984) Limited, 2019 

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Footnotes

Dr N Rossi takes responsibility for the integrity of the content of the paper

Presented at the 2018 American Academy of Otolaryngology – Head and Neck Surgery Foundation Annual Meeting and Otolaryngology Experience, 7–10 October 2018, Atlanta, GA, USA.

References

1Kitsko, D, Dedhia, K. Intracranial complications of otitis media. In: Myers, EN, Snyderman, CH, eds. Operative Otolaryngology: Head and Neck Surgery, 3rd edn. 2018;874–9Google Scholar
2Chole, R. Chronic otitis media, mastoiditis, and petrositis. In: Flint, PW, Haughey, BH, Lund, VJ, Niparko, JK, Robbins, KT, Thomas, JR, Lesperance, MM, eds. Cummings Otolaryngology: Head and Neck Surgery, 6th edn. Saunders: Philadelphia, 2015;2139–55Google Scholar
3Gadre, AK, Chole, RA. The changing face of petrous apicitis-a 40-year experience. Laryngoscope 2018;128:195–201Google Scholar
4Goldstein, NA, Casselbrant, ML, Bluestone, CD, Kurs-Lasky, M. Intratemporal complications of acute otitis media in infants and children. Otolaryngol Head Neck Surg 1998;119:444–54Google Scholar
5Goldenberg, D, Goldstein, BJ. Handbook of Otolaryngology: Head and Neck Surgery. New York: Thieme Medical Publishers, 2011Google Scholar
6Neely, G. Surgery of acute infections and their complications. In: Brackmann, D, Shelton, C, Arriaga, M, eds. Otologic Surgery, 4th edn. Philadelphia: Elsevier, 2016;154–62Google Scholar
7Kazemi, T. Acute otitis media-induced Gradenigo syndrome, a dramatic response to intravenous antibiotic. Iran J Otorhinolaryngol 2017;29:165–9Google Scholar
8Sears, W. Gradenigo syndrome. Laryngoscope 1927;37:32–44Google Scholar
9Meissner, C. Understanding otitis media in 2018. American Academy of Pediatrics News & Journals Gateway 2018;6:26Google Scholar
10Janjua, N, Bajalan, M, Potter, S, Whitney, A, Sipaul, F. Multidisciplinary care of a paediatric patient with Gradenigo's syndrome. BMJ Case Rep 2016;2016Google Scholar