Gradenigo's syndrome, also called Gradenigo-Lannois syndrome and petrous apicitis
, is a complication of otitis media and mastoiditis involving the apex of the petrous temporal bone.
002) between a positive apicitis
test and CFI of the operated knee (Table 6).
MRI detected mildly enhancing soft tissue that had filled the petrous apex; this finding was thought to represent either an inflammatory response or indolent petrous apicitis
rather than the presence of any residual tumor.
The mastoiditis, labyrinthitis, facial nerve palsy and petrous apicitis
are infratemporal complications of acute OM.
However, they belong to the PPS roof and, if present, they are potential sources of infection: the petrous apicitis
is an extension of infection from the mastoid air cell tract into a pneumatized anterior or posterior petrous apex.
Other extracranial complications include Bezold's abscess, labyrinthine fistulae, facial nerve paralysis and petrous apicitis
Acute otitis media induced petrous apicitis
presenting as the Gradenigo syndrome: successfully treated by ventilation tube insertion.
A number of lesions and disease processes have been described within the petrous apex, including cholesterol granulomas, petrous apicitis
, cerebrospinal fluid cysts, encephaloceles, epidermoids, effusions, mucoceles, carotid aneurysms, asymmetric pneumatization, chordomas, chondrosarcomas, metastases, paragangliomas (glomus tumors), meningiomas, and schwannomas, (1-8) Characteristic presenting symptoms, as well as findings on magnetic resonance imaging (MRI) and computed tomography (CT) scans, are essential for differentiation of the lesion.
Late complications include facial paralysis, labyrinthitis, postauricular fistulae, subperiosteal abscess, petrous apicitis
, and intracranial extension of infection.
A later coronal-projection CT showed definite bone destruction in the anterior petrous apex, confirming suspicions that a petrous apicitis
was responsible for the facial paralysis and abscess.
Simple fluid effusions can become infected and lead to bacterial petrous apicitis
, osteomyelitis, or chronic obstruction, which in turn can lead to the formation of petrous apex mucoceles.