tailieunhanh - Báo cáo y học: " Therapeutic approach to Gradenigo's syndrome: a case report."

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Therapeutic approach to Gradenigo's syndrome: a case report. | Kantas et al. Journal of Medical Case Reports 2010 4 151 http content 4 1 151 CASE REPORTS CASE REPORT Open Access Therapeutic approach to Gradenigo s syndrome a case report Ilias Kantas1 Anna Papadopoulou1 Dimitrios G Balatsouras 2 Andreas Aspris3 and Nikolaos Marangos1 Abstract Introduction Traditional management of Gradenigo s syndrome requires aggressive and radical surgery without any attempt to preserve hearing. Recent reports however describe a successful outcome after conservative surgical intervention without labyrinthectomy. A similar outcome has also been reported in patients who were only prescribed with antibiotics and did not undergo myringotomy. Case presentation We report the case of a 24-year-old Caucasian Greek woman with Gradenigo s syndrome who was treated by draining her petrous apex via an infralabyrithine approach between her posterior semicircular canal and the jugular bulb. Her inner ear was not sacrificed during the procedure. She presented pre-operatively with ipsilateral conductive hearing loss which recovered completely four weeks after the surgery. Conclusions Patients with Gradenigo s syndrome may be successfully treated with a combination of long-term permanent drainage and ventilation of the apical cells with corresponding hearing preservation. This can be achieved via a combination of transmastoid infralabyrinthine and suprajugular approaches if such would be allowed by the anatomy of the region or if there is enough space between the posterior semicircular canal and the jugular bulb. Introduction Apical petrositis was a common complication of acute mastoiditis prior to the widespread use of antibiotics. It reported occurred in 100 000 children with acute otitis media 1 . In 1907 Gradenigo described a syndrome characterized by a triad of symptoms related to apical petrositis. These symptoms include otorrhea and hearing loss deep facial pain resulting from trigeminal involvement and .