Gradenigo's syndrome is one of the rare complications of chronic otitis media. This slide presentation explains about Gradenigo's syndrome.

1. Gradenigo’s Syndrome
(Apex petrocitis)
Dr. Krishna Koirala
Manipal College of Medical
Sciences
Pokhara, Nepal

2. Acute Petrositis (Gradenigo’s syndrome)
• Involvement of petrous apex air cells in chronic otitis media
• Petrous apex cells are pneumatized in 20% cases only
• Difficult to manage due to
– Poor drainage
– Proximity to neurovascular structures
• Clinical Features
– Gradenigo’s Syndrome

4. 1. Persistent Ear Discharge in
spite of adequate cortical
mastoid surgery
2. Retro - Orbital Pain due to V
cranial nerve involvement
3. Medial Squint due to
Abducens Nerve involvement
Gradenigo’s Syndrome

6. Treatment
• Medical
•I.V. Antibiotics / Anti-Inflammatory agents
• Surgical
– Without residual hearing
•Trans-labyrinthine Route - Posterior cells
•Trans- cochlear Route - Anterior cells
– With residual hearing
•Retro-labyrinthine Route /Sub - arcuate Route - Posterior
cells
•Infra-cochlear Route /Sub- temporal Route - Anterior cells