Department of Otorhinolaryngology-Head and Neck Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
Clin Exp Otorhinolaryngol. 2014 Mar;7(1):59-62. doi: 10.3342/ceo.2014.7.1.59. Epub 2014 Feb 5.
Petrous apicitis is a rare but fatal complication of otitis media. An infection within the middle ear can extend within the temporal bone into the air cells of the petrous apex. With only the thin dura mater separating the trigeminal ganglion and the 6th cranial nerve from the bony petrous apex, they are vulnerable to inflammatory processes, resulting in deep facial pain, lateral rectus muscle paralysis, and diplopia. In 1904, Gradenigo described a triad of symptoms related to petrous apicitis, including acute suppurative otitis media, deep facial pain resulting from trigeminal involvement, and abducens nerve palsy. It has traditionally been treated with surgery, but recent advances in imaging, with improved antibiotic treatment, allow conservative management. In this case report, we describe a clinical and neuroradiological evolution of a child with a petrous apicitis after acute otitis media, which was managed medically with a positive outcome.
岩尖炎是中耳炎的一种罕见但致命的并发症。中耳的感染可向颞骨内的岩尖气房扩展。由于三叉神经节和第 6 颅神经与坚硬的岩尖之间只有薄薄的硬脑膜相隔，它们很容易受到炎症过程的影响，导致深部面部疼痛、外直肌瘫痪和复视。1904 年，Gradenigo 描述了一组与岩尖炎相关的三联征症状，包括急性化脓性中耳炎、三叉神经受累引起的深部面部疼痛和展神经瘫痪。传统上，该病采用手术治疗，但由于影像学的进步和抗生素治疗的改善，现在可以采用保守治疗。在本病例报告中，我们描述了一例急性中耳炎后继发岩尖炎的儿童的临床和神经影像学演变过程，该患儿经药物治疗后取得了良好的效果。
