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Gradenigo综合征的见解:病例报告与综述

Insights into Gradenigo syndrome: Case presentation and review.

作者信息

Horache Kenza, Jidal Manal, ElOuali Ibtissam, Saouab Rachida, Elfenni Jamal

机构信息

Radiology Department, Mohammed V military hospital of Rabat, Rabat, Morocco.

出版信息

Radiol Case Rep. 2024 Sep 3;19(11):5442-5446. doi: 10.1016/j.radcr.2024.08.002. eCollection 2024 Nov.

DOI:10.1016/j.radcr.2024.08.002
PMID:39285979
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11403888/
Abstract

Gradenigo syndrome (GS) is characterized by a triad of clinical features: abducens nerve palsy, retro-orbital pain, and otorrhea, arising as a complication of suppurative otitis media. Herein, we present a case of GS in a 15-year-old male patient, secondary to left otitis media. The patient exhibited fever, otorrhea, accompanied by diplopia, retrobulbar pain, and headache. Imaging studies demonstrated petrous bone destruction and inflammatory changes with opacification of petrous bone, mastoid cells and surrounding structures, confirming the diagnosis of GS. Treatment included intravenous antibiotics and anticoagulants, resulting in the resolution of symptoms and radiological improvement. GS, though rare, warrants prompt recognition and appropriate management to prevent severe complications. Diagnostic imaging plays a crucial role in evaluation, and treatment often involves prolonged antibiotic therapy and, in severe cases, surgical intervention. Understanding the clinical presentation and management strategies is essential for clinicians encountering this condition.

摘要

Gradenigo综合征(GS)的特征为三联征临床症状:展神经麻痹、眶后疼痛和耳漏,它是化脓性中耳炎的一种并发症。在此,我们报告一例15岁男性继发于左耳中耳炎的GS病例。该患者出现发热、耳漏,并伴有复视、球后疼痛和头痛。影像学检查显示岩骨破坏及炎性改变,岩骨、乳突小房和周围结构出现混浊,确诊为GS。治疗包括静脉使用抗生素和抗凝剂,症状得以缓解,影像学表现也有所改善。GS虽罕见,但需及时识别并进行恰当处理以预防严重并发症。诊断性影像学检查在评估中起关键作用,治疗通常需要长期使用抗生素,严重病例还需手术干预。了解临床表现和管理策略对遇到这种情况的临床医生至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f08d/11403888/5ef0649fc458/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f08d/11403888/426fc9bad978/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f08d/11403888/0b6d27cee4bc/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f08d/11403888/4a1b0f08d090/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f08d/11403888/5ef0649fc458/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f08d/11403888/426fc9bad978/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f08d/11403888/0b6d27cee4bc/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f08d/11403888/4a1b0f08d090/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f08d/11403888/5ef0649fc458/gr4.jpg

相似文献

1
Insights into Gradenigo syndrome: Case presentation and review.Gradenigo综合征的见解:病例报告与综述
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Petrositis With Bilateral Abducens Nerve Palsies complicated by Acute Otitis Media.伴有双侧展神经麻痹的 Petrositis 合并急性中耳炎。
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本文引用的文献

1
Gradenigo Syndrome in a 14-Year-old Girl as a Consequence of Otitis Media With Effusion.一名14岁女孩因分泌性中耳炎导致Gradenigo综合征。
J Neuroophthalmol. 2022 Mar 1;42(1):e408-e409. doi: 10.1097/WNO.0000000000001278. Epub 2021 Apr 26.
2
Diplopia in a Child: Gradenigo Syndrome Is an Unforgettable Disease.儿童复视:Gradenigo综合征是一种令人难忘的疾病。
Ear Nose Throat J. 2023 Feb;102(2):NP53-NP55. doi: 10.1177/0145561321989459. Epub 2021 Jan 28.
3
How well do we know Gradenigo? A comprehensive literature review and proposal for novel diagnostic categories of Gradenigo's syndrome.
我们对 Gradenigo 综合征了解多少?一项全面的文献回顾及 Gradenigo 综合征新诊断类别的建议。
Int J Pediatr Otorhinolaryngol. 2020 May;132:109942. doi: 10.1016/j.ijporl.2020.109942. Epub 2020 Feb 8.
4
Gradenigo Syndrome Induced by Suppurative Otitis Media.化脓性中耳炎所致Gradenigo综合征
J Craniofac Surg. 2018 Oct;29(7):e645-e646. doi: 10.1097/SCS.0000000000004660.
5
The Forgotten Syndrome? Four Cases of Gradenigo's Syndrome and a Review of the Literature.被遗忘的综合征?四例Gradenigo综合征及文献综述
Strabismus. 2016;24(1):21-7. doi: 10.3109/09273972.2015.1130067. Epub 2016 Mar 16.
6
Are topical antibiotics an alternative to oral antibiotics for children with acute otitis media and ear discharge?对于患有急性中耳炎且有耳漏的儿童,局部用抗生素能否替代口服抗生素?
BMJ. 2016 Feb 4;352:i308. doi: 10.1136/bmj.i308.
7
Conservative management of Gradenigo's syndrome in a child.儿童Gradenigo综合征的保守治疗
BMJ Case Rep. 2011 Apr 19;2011:bcr0320113978. doi: 10.1136/bcr.03.2011.3978.
8
Gradenigo's Syndrome: Beyond the Classical Triad of Diplopia, Facial Pain and Otorrhea.格拉代尼戈综合征:超越复视、面部疼痛和耳漏的经典三联征。
Case Rep Neurol. 2011 Feb 15;3(1):45-7. doi: 10.1159/000324179.
9
Diffusion-weighted MRI identifies petrous apex abscess in Gradenigo syndrome.弥散加权 MRI 可识别 Gradenigo 综合征中的岩尖脓肿。
J Neuroophthalmol. 2010 Mar;30(1):34-6. doi: 10.1097/WNO.0b013e3181c5d0fd.
10
Gradenigo's syndrome.格拉代尼戈综合征
J Emerg Med. 2010 May;38(4):449-51. doi: 10.1016/j.jemermed.2007.08.074. Epub 2008 Mar 4.