Abducens nerve palsy as the sole presenting symptom of petrous apicitis

2002 ◽  
Vol 116 (9) ◽  
pp. 726-729 ◽  
Author(s):  
T. Price ◽  
G. Fayad
Keyword(s):  
Otitis Media ◽  
Facial Pain ◽  
Nerve Palsy ◽  
Abducens Nerve ◽  
Fatal Complication ◽  
Suppurative Otitis Media ◽  
Abducens Paralysis ◽  
Delayed Recognition ◽  
Petrous Apicitis ◽  
Reliable Sign

Petrous apicitis as a potentially fatal complication of suppurative otitis media presents in a variety of forms. Gradenigo’s triad of abducens paralysis, deep facial pain due to trigeminal involvement and acute suppurative otitis media rarely occurs. The conflicting symptoms reported in the literature usually result in the delayed recognition of the condition with potentially disastrous consequences. The VIth nerve palsy is considered to be the least reliable sign as it is least often present. We present a case in which it was the sole presenting symptom.

Diplopia in a Child: Gradenigo Syndrome Is an Unforgettable Disease

2021 ◽  
pp. 014556132198945
Author(s):  
Kai-Chieh Chan ◽  
Shih-Lung Chen
Keyword(s):  
Differential Diagnosis ◽  
Otitis Media ◽  
Nerve Palsy ◽  
Abducens Nerve ◽  
Modern Society ◽  
Abducens Nerve Palsy ◽  
Suppurative Otitis Media ◽  
Orbital Pain ◽  
Clinical Triad ◽  
Apical Petrositis

Gradenigo syndrome is a clinical triad of abducens nerve palsy, retro-orbital pain (trigeminal ganglionitis), and chronic otorrhea (otitis media). The etiology of Gradenigo syndrome results from apical petrositis secondary to suppurative otitis media. Although apical petrositis has gradually become uncommon in modern society due to the widespread use of antibiotics, Gradenigo syndrome should be considered in the differential diagnosis of a child’s diplopia.

Bilateral facial nerve palsy following secretory otitis media

1989 ◽  
Vol 103 (7) ◽  
pp. 685-685 ◽  
Author(s):  
D. J. Premachandra ◽  
G. Radcliffe
Keyword(s):  
Facial Nerve ◽  
Otitis Media ◽  
World Literature ◽  
Nerve Palsy ◽  
Facial Nerve Palsy ◽  
Secretory Otitis Media ◽  
Suppurative Otitis Media ◽  
The World

AbstractFacial nerve palsy is a known complication of acute suppurative otitis media. Cases of facial nerve palsy following secretory otitis media have not been reported in the world literature. We report a case of bilateral facial nerve palsy following secretory otitis media.

scholarly journals Rare case of chronic suppurative otitis media with gradenigo syndrome

2017 ◽  
Vol 3 (3) ◽  
pp. 755 ◽  
Author(s):  
Shiffali . ◽  
Priyanka . ◽  
Kulwinder Singh Sandhu ◽  
Jagdeepak Singh
Keyword(s):  
Otitis Media ◽  
Nerve Palsy ◽  
Rare Complication ◽  
Acute Otitis Media ◽  
Suppurative Otitis Media ◽  
Sixth Nerve Palsy ◽  
Modified Radical Mastoidectomy ◽  
Clinical Triad ◽  
Apical Petrositis ◽  
Sixth Nerve

<p class="abstract">We report a case of sixth nerve palsy as a rare complication of acute otitis media (apical petrositis). The clinical triad of symptoms consisting of retro-orbital unilateral pain related to trigeminal nerve involvement, diplopia due to sixth nerve palsy and persistent otorrhea is known as Gradenigo syndrome. The patient was treated with intravenous antibiotics along with modified radical mastoidectomy and had complete resolution of his symptoms.</p>

scholarly journals Vocal Cord Paralysis and Dysphagia as Sequelae of Gradenigo Syndrome

2018 ◽  
Vol 28 (1) ◽  
pp. 15-18
Author(s):  
Mary Ann V. Macasaet ◽  
Emmanuel Tadeus S. Cruz
Keyword(s):  
Vocal Cord ◽  
Otitis Media ◽  
Middle Ear ◽  
Vocal Cord Paralysis ◽  
Petrous Apex ◽  
Suppurative Otitis Media ◽  
Ear Infection ◽  
Nerve Paralysis ◽  
Middle Ear Infection ◽  
Petrous Apicitis

Objectives:     To present a case of vocal cord paralysis and dysphagia developing in Gradenigo syndrome and to discuss its clinical presentation, differential diagnosis and therapeutic approach.   Methods:             Design: Case Report             Setting:  Tertiary Government Hospital             Patient: One   Results:  A 54-year-old lady was admitted with a six month history of left-sided otorrhea, cheek and jaw pain, three months otalgia, and recent-onset hoarseness, dysphagia and diplopia on a background of mastoidectomy at age 6. Otoscopy revealed granulation tissue and chlolesteatoma occupying the left external auditory canal. There was left vocal cord paralysis with pooling of saliva in the pyriform sinus, left lateral gaze paralysis, and left facial nerve paralysis. CT scan revealed sclerosis of the left petrous apex and leptomeningeal enhancement on the left temporal lobe. Chronic suppurative otitis media with cholesteatoma and Gradenigo syndrome was diagnosed, and canal wall down mastoidectomy was performed Postoperatively, the otalgia and pain over the left jaw diminished in intensity while hoarseness and left lateral gaze palsy remained.   Conclusion: Gradenigo syndrome is known for its triad of retro-orbital pain, lateral gaze paralysis, and chronic middle ear infection due to petrous apicitis. Although rare, vocal cord paralysis and dysphagia may develop when infection traverses and encroaches on the jugular foramen where cranial nerves IX, X, and XI are lodged.  Knowledge of the syndrome should not be limited or confined to the classic triad.  Practicing ear specialists should be vigilant and cognizant of the clinical manifestations and sequelae of chronic middle ear infection. Prompt surgical intervention is crucial while resolution of the disease may vary for different individuals.   Keywords: Chronic otitis media, Gradenigo syndrome, vocal cord paralysis, petrous apicitis  

scholarly journals Non-cholesteatomatous suppurative otitis media: facial nerve palsy in an immunocompromised patient

1995 ◽  
Vol 109 (8) ◽  
pp. 755-758 ◽  
Author(s):  
C. Hartley ◽  
S. R. Saeed ◽  
T. J. Lyons
Keyword(s):  
Renal Transplantation ◽  
Facial Nerve ◽  
Otitis Media ◽  
Nerve Palsy ◽  
Facial Nerve Palsy ◽  
Immunocompromised Patient ◽  
Horizontal Segment ◽  
Suppurative Otitis Media ◽  
History Of

AbstractA 47-year-old man developed a complete facial nerve palsy secondary to non-cholesteatomatous suppurative otitis media. At operation, this was seen to be due to destruction of the nerve from halfway along the horizontal segment to a point just distal to the second genu. The history of recent renal transplantation and subsequent immunosuppression was judged to be significant in the pathogenesis of the palsy.

scholarly journals The Importance of Duration in the Prognosis of Facial Nerve Palsy and Its Treatment-A Case Report

2021 ◽  
Vol 6 (2) ◽  
Author(s):  
Paramita Debnath
Keyword(s):  
Case Report ◽  
Facial Nerve ◽  
Otitis Media ◽  
Social Life ◽  
Nerve Palsy ◽  
Facial Nerve Palsy ◽  
Chronic Suppurative Otitis Media ◽  
Good Effect ◽  
Surgical Approaches ◽  
Suppurative Otitis Media

Background: Facial nerve palsy is considered to be one of the most common consequence of untreated chronic suppurative otitis media. The incidence has significantly reduced over the decade due to better imaging technology and use of early antibiotics and better surgical procedures but if left untreated, it has a significant impact over the patient’s day to day life and markedly affects patient’s social life and causes serious psychological damage. An appropriate and prompt management ensures healing of the palsy without sequelae. Case Report: We report a case of bilateral chronic suppurative otitis media with unilateral right grade 4 facial nerve palsy which happened within a duration of 1 month for which patient underwent right modified radical mastoidectomy following which she had steady improvement. Conclusion: This case highlights that in patients with middle-ear cleft cholesteatoma the surgical approaches vary according to duration of palsy and post-operative improvement in facial nerve function can be anticipated in cases of acute palsy. Surgical interventions have been proved to have a good effect in restoration of facial nerve palsy in cases of shorter duration as compared to those of sudden onset and longer duration.

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