Gadre Arun K, Chole Richard A
Department of Otolaryngology-Head and Neck Surgery, Heuser Hearing Institute, University of Louisville, Louisville, Kentucky, U.S.A.
Department of Surgery, Heuser Hearing Institute, University of Louisville, Louisville, Kentucky, U.S.A.
Laryngoscope. 2018 Jan;128(1):195-201. doi: 10.1002/lary.26571. Epub 2017 Apr 5.
OBJECTIVES/HYPOTHESIS: Petrous apicitis (PA) is a rare complication of otitis media. Gradenigo syndrome, with the classic triad of otitis, deep pain, and abducens paralysis, is rarer still. The objective of this study was to determine if clinical presentation and management has changed over time.
Retrospective chart review.
Forty-four patients with PA over a 40-year period were studied. Symptoms, signs, and management outcomes were studied. Historical review, surgical anatomy and approaches, pathology, and microbiology, and an illustrative case are included as appendices.
The classical Gradenigo triad of retro-orbital pain, otitis, and abducens palsy occurred in only six of 44 patients (13.6%). Over the 40-year observation period, those needing surgery has decreased.
Antibiotics remain the primary treatment modality. Surgery is reserved for cases failing to respond to antibiotics. One of the 44 patients in this series died of his disease. Diagnosis and management algorithms based on these observations are suggested.
目的/假设：岩尖炎（PA）是中耳炎的一种罕见并发症。Gradenigo综合征，具有中耳炎、深部疼痛和展神经麻痹的典型三联征，更为罕见。本研究的目的是确定临床表现和治疗方法是否随时间发生了变化。
回顾性病历审查。
对40年间的44例岩尖炎患者进行了研究。对症状、体征和治疗结果进行了研究。历史回顾、手术解剖与入路、病理学、微生物学以及一个典型病例作为附录包含在内。
44例患者中只有6例（13.6%）出现了眶后疼痛、中耳炎和展神经麻痹的经典Gradenigo三联征。在40年的观察期内，需要手术的患者数量有所减少。
抗生素仍然是主要的治疗方式。手术仅用于对抗生素无反应的病例。该系列中的44例患者中有1例死于该病。基于这些观察结果提出了诊断和治疗算法。
4。《喉镜》，128:195 - 201，2018年。
