2021
DOI: 10.1016/j.radcr.2021.09.026
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An unusual case of acute otitis media resulting in Gradenigo syndrome: CT and MRI findings

Abstract: With the widespread use of antibiotics, Gradenigo syndrome is a rare complication of acute otitis media (AOM) and acute mastoiditis. It is an uncommon form of petrous apicitis and can be life-threatening. We report the case of a 14-year-old female with unresolved AOM, who developed otorrhea, ipsilateral headaches, diplopia and raised inflammatory markers. Magnetic Resonance Imaging (MRI) demonstrated features of petrous apicitis and confirmed the suspicion of Gradenigo syndrome. The objective of this clinical … Show more

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Cited by 3 publications
(5 citation statements)
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“…CT is a fast, sensitive and widely available exam. However, MRI is more specific for detecting involvement of petrous apex structures such as nerves, possible underlying osteomyelitis, neoplasms, and meningitis [33,34]. A hypointense signal on a T1-weighted image and a hyperintense T2-weighted image with/without an enhancement edge are signs of PA on MRI.…”
Section: Discussionmentioning
confidence: 99%
“…CT is a fast, sensitive and widely available exam. However, MRI is more specific for detecting involvement of petrous apex structures such as nerves, possible underlying osteomyelitis, neoplasms, and meningitis [33,34]. A hypointense signal on a T1-weighted image and a hyperintense T2-weighted image with/without an enhancement edge are signs of PA on MRI.…”
Section: Discussionmentioning
confidence: 99%
“…So CT imagine shows strong characteristic, it can sometime be mis diagnosed as middle ear mastoiditis. In addition, the petrous apex is a complex area with multiple variations that can be bilaterally symmetric or asymmetric [ 11 ]. This makes CT judgment more challenging.…”
Section: Discussionmentioning
confidence: 99%
“…Imaging findings include bone destruction and opacifications of the mastoid air cells with or without extensive fluid in the left middle ear [74,75]. Changes in bone structures include erosive lysis with ill-defined irregular edges in the petrous apex [76]. The characteristic feature is permeative destruction of the bony structures in this region; however, bone loss occurs in later disease stages [76].…”
Section: Gradenigo's Syndromementioning
confidence: 99%
“…Changes in bone structures include erosive lysis with ill-defined irregular edges in the petrous apex [76]. The characteristic feature is permeative destruction of the bony structures in this region; however, bone loss occurs in later disease stages [76].…”
Section: Gradenigo's Syndromementioning
confidence: 99%
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