Gradenigo's syndrome secondary to chronic otitis media on a background of previous radical mastoidectomy: A case report

被引：18
作者：
Plodpai Y. [1 ]
Hirunpat S. [2 ]
Kiddee W. [3 ]
机构：
[1] Department of Otolaryngology, Faculty of Medicine, Prince of Songkla University, Hatyai
[2] Department of Radiology, Faculty of Medicine, Prince of Songkla University, Hatyai
[3] Department of Ophthalmology, Faculty of Medicine, Prince of Songkla University, Hatyai
来源：
Journal of Medical Case Reports | / 8卷 / 1期
关键词：
Gradenigo's syndrome; Mastoidectomy; Petrous apicitis;
D O I：
10.1186/1752-1947-8-217
中图分类号：
学科分类号：
摘要：
Introduction. Gradenigo's syndrome is nowadays a rare condition characterized by a triad of otorrhea, facial pain with trigeminal nerve involvement and abducens nerve palsy. Most cases are caused by medial extension of acute otitis media into a pneumatized petrous apex and surgical drainage is usually the treatment of choice. We present a case highlighting the pathological mechanism of this disease, demonstrate rare radiological findings associated with this patient, and showcase successful medical treatment without surgical intervention. Case presentation. A 63-year-old Thai man presented with complete Gradenigo triad as a complication of chronic otomastoiditis in spite of clinical history of previous radical mastoidectomy and a nonpneumatization of the petrous apex. Magnetic resonance imaging showed abnormal prominent enhancement at the roof of his right temporal bone, and the dura overlying the floor of right middle cranial fossa and right cavernous sinus. Magnetic resonance imaging also detected right petrous apicitis. With the use of intravenous antibiotics and topical antibiotic eardrops, recovery was observed within 5 days with complete resolution within 2 months. Conclusions: Although there is little evidence to support the use of medical therapy in the treatment of Gradenigo's syndrome resulting from chronic ear disease, we here demonstrate successful conservative treatment of Gradenigo's syndrome following chronic otitis media in a patient who underwent previous radical mastoidectomy. © 2014 Plodpai et al.; licensee BioMed Central Ltd.
引用
收藏
相关论文
共 12 条
  • [1] Homer J.J., Johnson I.J.M., Jones N.S., Middle ear infection and sixth nerve palsy, Journal of Laryngology and Otology, 110, 9, pp. 872-874, (1996)
  • [2] Lutter S.A., Kerschner J.E., Chusid M.J., Gradenigo syndrome: A rare but serious complication of otitis media, Pediatric Emergency Care, 21, 6, pp. 384-386, (2005)
  • [3] Tornabene S., Vilke G.M., Gradenigo's syndrome, J Emerg Med, 38, pp. 449-451, (2010)
  • [4] Scardapane A., Del Torto M., Nozzi M., Elio C., Breda L., Chiarelli F., Gradenigo's syndrome with lateral venous sinus thrombosis: Successful conservative treatment, Eur J Pediatr, 169, pp. 437-440, (2010)
  • [5] Marianowski R., Rocton S., Ait-Amer J.L., Morisseau-Durand M.P., Manach Y., Conservative management of Gradenigo syndrome in a child, International Journal of Pediatric Otorhinolaryngology, 57, 1, pp. 79-83, (2001)
  • [6] Burston B.J., Pretorius P.M., Ramsden J.D., Gradenigo's syndrome: Successful conservative treatment in adult and paediatric patients, Journal of Laryngology and Otology, 119, 4, pp. 325-329, (2005)
  • [7] Rossor T.E., Anderson Y.C., Steventon N.B., Voss L.M., Conservative management of Gradenigo's syndrome in a child, BMJ Case Rep
  • [8] Gibier L., Darrouzet V., Franco-Vidal V., Gradenigo syndrome without acute otitis media, Pediatr Neurol, 41, pp. 215-219, (2009)
  • [9] Kong S.-K., Lee I.-W., Goh E.-K., Park S.-E., Acute otitis media-induced petrous apicitis presenting as the Gradenigo syndrome: Successfully treated by ventilation tube insertion, Am J Otolaryngol, 32, pp. 445-457, (2011)
  • [10] Ibrahim M., Shah G., Parmar H., Diffusion-weighted MRI identifies petrous apex abscess in Gradenigo syndrome, J Neuroophthalmol, 30, pp. 34-36, (2010)
12