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Petrous Apicitis: A Systematic Review and Case Presentation
Guy Talmor1, Mayand Vakil, Chris Tseng
1Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey.
Summary
Petrous apicitis (PA) is a rare complication of middle ear infections. Early diagnosis and treatment, including antibiotics and surgery, can prevent severe outcomes.
Area of Science:
- Otolaryngology
- Infectious Diseases
- Neurosurgery
Background:
- Petrous apicitis (PA) is a rare but serious complication of acute otitis media.
- This study reviews the clinical presentation, diagnosis, management, and outcomes of PA in the antibiotic era.
Observation:
- A systematic review included 67 studies with 134 patients diagnosed with PA.
- The most common preceding condition was acute otitis media (58.2%).
- Gradenigo's triad was uncommon (20.9%), but individual symptoms like retro-orbital pain (64.2%) were frequent.
Findings:
- Pseudomonas was the most common pathogen (34.2%).
- Computed tomography was the primary imaging modality (56.0%).
- Most patients received antibiotics (95.6%), and many underwent surgery (67.9%).
Implications:
- Petrous apicitis presents variably and can lead to severe morbidity.
- Low mortality rates are achievable with prompt medical and surgical management.
- Early intervention can prevent long-term sequelae of petrous apicitis.
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