Donald, "Petrous apicitis
, clinical considerations," Annals of Otology, Rhinology, and Laryngology, vol.
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.
A standardized clinical examination was done for all patients, including what we call the "apicitis
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.
Complications of CSOM are broadly classified into intratemporal (Coalescent mastoidoitis, facial nerve palsy, labyrinthitis and petrous apicitis
) and intracranial complications (Meningitis, Extradural abscess, Subdural abscess, Brain abscess, Sigmoid sinus thrombosis and Otitic hydrocephalus).
Late complications include facial paralysis, labyrinthitis, postauricular fistulae, subperiosteal abscess, petrous apicitis
, and intracranial extension of infection.