1997 Volume 43 Issue 5Supplement3 Pages 726-729
Gradenigo's syndorome consists of three main symptoms, including: otitis media, abducens nerve paralysis, and trigeminal nerve irritation. In Japan, only 12 cases with this syndrome were reported from 1965 to 1995. A 45-years-old man initially complained of right otalgia and trigeminal neuralgia, while right abducens nerve paralysis appeared about two weeks after onset of acute otitis media. A CT scan showed an extradural abscess in the right petrous apex. A right extended mastoidectomy and petrosectomy was thus performed due to the fact that chemotherapy was not effective. Within a few days, the trigeminal decreased and the functin of the right abducent nerve recovered completely within about two weeks after the operation. Occasionally, an inflammation of the middle ear may extend to the petrous apex in ears with an excellent pneumatization of the temporal bone as seen in the above discrebed patient. it is therefore necessary to be aware of this phenomenon when treating such patients.