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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
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

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