Gradenigo syndrome: an unexpected otitis complication

  • Catarina Mendes Paediatric Service of Centro Hospitalar do Porto
  • Cristina Garrido Paediatric Service of Centro Hospitalar do Porto
  • Margarida Guedes Paediatric Service of Centro Hospitalar do Porto
  • Laura Marques Paediatric Service of Centro Hospitalar do Porto
Keywords: Gradenigo, otitis media, petrositis

Abstract

Introduction: Gradenigo syndrome (also known as apical petrositis) is a clinical triad of otitis media, trigeminal neuralgia and ipsilateral abducens nerve palsy. In the era of antibiotic therapy, it is an exceptional but potentially life threatening complication of acute otitis media, requiring prompt diagnosis and treatment.

Case report: A seven-year-old girl with previous history of otitis, presented with left ear pain, headache, diplopia and fever. Diagnosis of Gradenigo syndrome was established and she was treated with systemic broad-spectrum antibiotics and myringotomy with timpanostomy tube placement. Clinical outcome was favourable.

Conclusion: This case documents therapeutic success and total recovery with a conservative approach in an immunocompetent child with Gradenigo syndrome.

References

Gradenigo G. Über die paralyse des nervus abducens bei otitis. Arch Ohrenheilk 1907; 774:149-87.

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; 57:79-83.

Finkelstein Y, Marcus N, Mosseri R, Bar-Sever Z, Garty BZ. Streptococcus acidominimus infection in a child causing Gradenigo syndrome. Int J Pediatr Otorhinolaryngol 2003; 67:815-7.

Gibier L, Darrouzet V, Franco-Vidal V. Gradenigo syndrome without acute otitis media. Pediatr Neurol 2009; 41:215-9.

Goldstein NA, Casselbrandt ML, Bluestone CD, Kurs-Lasky M. Intratemporal complications of acute otitis media in infants and children. Otolaryngol Head Neck Surg 1998; 119:444-54.

Dorn M, Liener K, Rozsasi A, Keck T. Prolonged diplopia following sinus vein mimicking Gradenigo’s syndrome. Int J Pediatr Otorhinolaryngol 2006; 70:741-3.

Guedes V, Gallegos P, Ferrero A, García-Minúzzi M, Casanovas A, Georgetti B, et al. Gradenigo’s syndrome: a casereport. Arch Argent Pediatr 2010; 108:e74-e75.

Kong SK, Lee IW, Goh EK, Park SE. Acute otitis mediainduced petrous apicitis presenting as the Gradenigo syndrome: successfully treated by ventilation tube insertion. Am J Otolaryngol 2011; 32:445-7.

Luntz M, Brodsky A, Nusem S, Kronenberg J, Keren G, Migirov L, et al. Acute mastoiditis - the antibiotic era: a multicenter study. Int J Pediatr Otorhinolaryngol 2001; 57:1-9.

Jacobsen CL, Bruhn MA, Yavarian Y, Gaihede M. Mastoiditis and Gradenigo’s Syndrome with anaerobic bacteria. BMC Ear, Nose and Throat Disorders 2012; 12:10.

Published
2016-02-23
How to Cite
Mendes, C., Garrido, C., Guedes, M., & Marques, L. (2016). Gradenigo syndrome: an unexpected otitis complication. NASCER E CRESCER - BIRTH AND GROWTH MEDICAL JOURNAL, 23(1), 25-28. https://doi.org/10.25753/BirthGrowthMJ.v23.i1.8588
Section
Case Reports