petrotitis; petrous apicitis; Gradenigo's syndrome
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Introduction
inflammation of the petrous process of the temporal bone
Etiology
Pathology
- inflammation extends from petrous process of the temporal bone which surround the ear into the inner ear
- cranial nerve 5 irritation due to proximity of the Gasserian ganglion in relation to the petrous process
Clinical manifestations
- otorrhoea
- deep retro-orbital pain, facial pain or headache
- cranial nerve 6 paresis, leading to a lateral rectus palsy
- otalgia
- fever.
- confusion, impaired consciousness, coma
- other cranial nerve palsies
Laboratory
- complete blood count may show leukocytosis
- erythrocyte sedimentation rate &/or serum CRP may be elevated
- culture & sensitivity of otorrhea
Diagnostic procedures
- biopsy rarely needed
- audiometry
Radiology
Management
- intravenous antibiotics selected from culture & sensitivity
- surgical drainage
- patients who do not respond to antibiotics
- complications
- cranial nerve palsy
- abscess
- venous sinus thrombosis
More general terms
References
- ↑ Petrotitis University of Tennessee Medical Center http://www.utmedicalcenter.org/your-health/encyclopedia/disease/001254/
- ↑ MedlinePlus: Petrotitis http://www.nlm.nih.gov/medlineplus/ency/article/001254.htm
- ↑ Petrotitis: Patient.co.uk http://www.patient.co.uk/doctor/Petrositis.htm
- ↑ Harrison's Principles of Internal Medicine, 13th ed. Isselbacher et al (eds), McGraw-Hill Inc. NY, 1994, pg 518