2020 Volume 63 Issue 5 Pages 221-227
Gradenigo syndrome was first reported by Giuseppe Gradenigo in 1904. The three characteristic features of the syndrome are otitis media, trigeminal neuralgia, and abducens nerve paralysis. Inflammation spreads from the middle ear (otitis media) to the apex of the petrous bone, affecting the trigeminal nerve and abducens nerve. The patient reported herein was a 10-year-old girl. She presented with the complaints of temporal and postauricular, but examination at a pediatric otorhinolaryngology clinic failed to reveal any abnormal findings. Therefore, the patient was prescribed only analgesics and followed up, but presented with abducens nerve palsy about a month later. Examination at our hospital revealed findings suggestive of otitis media, and the patient was diagnosed as a case of Gradenigo syndrome, based on the presence of the three main features. Conservative treatment with antibiotics was successful, with marked improvement of the symptoms and clinical findings, and she was discharged 10 days after the start of treatment. Based on the CT and MRI findings, and also the clinical response to treatment, we determined that primary petrositis was the underlying cause. At 6 months after discharge, there is no evidence of recurrence and the patient is doing well.
In recent years, the onset of this syndrome has become rare due to the widespread use of antibiotics. It is important to conduct a detailed examination with imaging studies, even if the eardrum is normal, in patients presenting with persistent ear pain for more than a week.
