Gradenigo’s syndrome with abscess of the petrous apex in pediatric patients: what is the best treatment?

Salvatore Savasta, Pietro Canzi, Federico Aprile, Alexandre Michev, Thomas Foiadelli, Marco Manfrin, Marco Benazzo

Research output: Contribution to journalArticle

Abstract

Background: Gradenigo’s syndrome is defined by the classic clinical triad of ear discharge, trigeminal pain, and abducens nerve palsy. It has become a very rare nosological entity after the introduction of antibiotics, so that has been defined as the “forgotten syndrome.” However, the underlying pathological process (apical petrositis) still represents a life-threatening condition that shall be immediately recognized in order to address the patient to the proper therapy. The therapy itself may be an argument of discussion: on a historical background ruled by surgery, reports of successful conservative antibiotic treatment have risen in recent years. Methods and Results: We reported a case of Gradenigo’s syndrome in a child with an abscess of the left petrous apex and initial involvement of the carotid artery. After multidisciplinary evaluation, we decided to encourage conservative treatment, until complete regression was observed. Discussion: The available literature of the last 10 years was reviewed, with particular attention to the presence of an apical abscess and the therapeutic approach. The principles of management with regard to conservative therapy versus surgical indications are therefore examined and discussed.

Original languageEnglish
JournalChild's Nervous System
DOIs
Publication statusPublished - Jan 1 2019

Fingerprint

Abscess
Pediatrics
Petrositis
Abducens Nerve Diseases
Anti-Bacterial Agents
Trigeminal Nerve
Pathologic Processes
Carotid Arteries
Ear
Therapeutics
Pain
Conservative Treatment

Keywords

  • Abducens
  • Antibiotic
  • Apicitis
  • Conservative
  • Surgery

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Clinical Neurology

Cite this

Gradenigo’s syndrome with abscess of the petrous apex in pediatric patients : what is the best treatment? / Savasta, Salvatore; Canzi, Pietro; Aprile, Federico; Michev, Alexandre; Foiadelli, Thomas; Manfrin, Marco; Benazzo, Marco.

In: Child's Nervous System, 01.01.2019.

Research output: Contribution to journalArticle

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