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Gradenigo's Syndrome and Labyrinthitis: Conservative versus Surgical Treatment.

Ahmad Al-Juboori1,2, Amira Nasser Al Hail1,2

  • 1Otorhinolaryngology, Head & Neck Surgery (ORL-HNS) Department, Al Wakra Hospital, Hamad Medical Corporation, Doha, Qatar.

Case Reports in Otolaryngology
|August 30, 2018
PubMed
Summary

Conservative treatment successfully managed Gradenigo's syndrome in a patient with chronic suppurative otitis media (CSOM). This rare complication, characterized by ear infection, trigeminal nerve pain, and sixth nerve palsy, showed symptom improvement with antibiotics.

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Area of Science:

  • Otolaryngology
  • Neurology
  • Infectious Diseases

Background:

  • Extracranial intratemporal complications of chronic suppurative otitis media (CSOM) are rare.
  • Gradenigo's syndrome presents as a triad: otitis media, trigeminal neuralgia, and abducens nerve (sixth cranial nerve) palsy.

Observation:

  • A 61-year-old male presented with chronic left ear discharge, headache, diplopia, vertigo, tinnitus, and hearing loss.
  • MRI revealed petrositis and an enhancing lesion in the left internal auditory meatus affecting the 7th-8th cranial nerves.

Findings:

  • The patient received conservative treatment with systemic and local antimicrobial agents.
  • Significant improvement was observed in ear discharge, vertigo, and diplopia.
  • Hearing loss and tinnitus showed no remarkable response to conservative management.

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Implications:

  • This case demonstrates the successful conservative management of Gradenigo's syndrome in the context of chronic ear disease.
  • Conservative treatment may be a viable option for Gradenigo's syndrome, despite limited supporting evidence.
  • Further research is warranted to establish definitive treatment guidelines for this rare complication.