Gradenigo syndrome: treatment and sequels
DOI:
https://doi.org/10.34631/sporl.764Keywords:
Gradenigo's syndrome, Apical petrositis, complications of otitis mediaAbstract
A 41-year-old female, went to emergency department for horizontal diplopia, facial pain, otorrhea, hearing loss and left otalgia, with a week of evolution. The fisical examination reveled limitation of the left eye abduction, exudate in middle left ear, abcense of facial palsy or spontaneous nystagmus. Of the complementary study carried out, the following stand out: evidence of left apical petrositis, left cavernous sinus thrombosis and partial occlusion of the petrous segment of the internal carotid artery. The medical treatment consisted of corticotherapy, wide-spectrum antibiotic therapy and antiaggregation. Surgical treatment included myringotomy at the emergency department, with collection of exudate, and mastoidectomy one week after the beginning of the treatment. In the follow-up, a complete recovery of the ocular movements of the left eye was observed, but there was a worsening of the auditory function.
References
- Gradenigo G. Über die paralyse des nervus abducens bei otitis. Arch Ohrenheilk 1907 Dec; 74(1):149-87.
- Chole R. Chronic otitis media, mastoiditis, and petrositis. In: Flint PW, Haughey BH, Lund VJ, Niparko JK, Robbins KT, Thomas JR, Lesperance MM. Cummings Otolaryngology: Head and Neck Surgery, 6th ed. Philadelphia: Saunders; 2015 p. 2139–55
- Gadre AK, Chole RA. The changing face of petrous apicitis-a 40-year experience. Laryngoscope. 2018 Jan;128(1):195-201.
- Renata Rennó Schiavetto, Daniel Martiniano Haber, Lauana Renata Cancian, Claudia Pereira Maniglia, Fernando Drimel Molina Gradenigo’s Syndrome as a First Manifestation of Rhabdomyosarcoma. Int. Arch. Otorhinolaryngol. 2009 Jul/Set;13(3):326-33.
–Vitale M, Amrit M, Arora R, Lata J. Gradenigo's syndrome: A common infection with uncommon consequences. Am J Emerg Med. 2017 Sep;35(9):1388.e1-1388.e2.
– Suzich KL, Adelson S, Choi CS. An Interesting Case of Gradenigo Syndrome. J Binocul Vis Ocul Motil. 2019 Jan-Mar;69(1):1-2
- Jensen PV, Hansen MS, Møller MN, et al. The Forgotten Syndrome? Four cases of Gradenigo’s syndrome and a review of the literature. Strabismus. 2016;24(1):21-7.
- Taklalsingh N, Falcone F, Velayudhan V. Gradenigo's Syndrome in a Patient with Chronic Suppurative Otitis Media, Petrous Apicitis, and Meningitis. Am J Case Rep. 2017 Sep 28;18:1039-1043.
- Kantas I, Papadopoulou A, Balatsouras D, Aspris A, Marangos N. Therapeutic approach to Gradenigo's syndrome: a case report. J Med Case Rep. 2010 May 24;4:151.
- Kazemi T. Acute otitis media-induced Gradenigo syndrome, a dramatic response to intravenous antibiotic. Iran J Otorhinolaryngol. 2017 May;29(92):165-169.
- Plodpai Y, Hirunpat S, Kiddee W. Gradenigo’s syndrome secondary to chronic otitis media on a background of previous radical mastoidectomy: a case report. J Med Case Rep. 2014 Jun 23;8:217.