title: Gradenigo's syndrome with lateral venous sinus thrombosis: successful conservative treatment.
abstract: Gradenigo's syndrome (GS) is a rare disease characterised by the triad otitis media, pain in the region innervated by the first and the second division of trigeminal nerve and abducens nerve palsy. Septic sinus thrombosis is one of the most frequent and relevant complication of GS; it is often due to persistent damage and late diagnosis. Computed tomography (CT) scan and magnetic resonance imaging (MRI) allow the correct diagnosis in most cases. Surgical therapy may be necessary for a better and more rapid resolution of the disease. We report the case of a 4-year-old child that was admitted for facial nerve palsy and abducens nerve palsy subsequent to a 2-week persistent pain in the right ear. MRI showed infective acute process of the right mastoid and partial ipsilateral sinus thrombophlebitis. The child was treated with high-dose intravenous antibiotics and with oral anticoagulants. A complete resolution of symptoms and radiological alterations were observed within 7 weeks. In conclusion, lateral sinus thrombosis and Gradenigo's syndrome are rare but potential fatal complications of otitis media and mastoiditis. High-dose intravenous antibiotics and a low dose of anticoagulant can achieve a complete recovery without surgery.
authors.affiliation: Department of Paediatrics, University of Chieti, Ospedale Policlinico, Via dei Vestini, 5, 66013, Chieti, Italy. a.scardapane@gmail.com
authors.forename: Alessandra
authors.initials: A
authors.lastname: Scardapane
authors.forename: Marianna
authors.initials: M
authors.lastname: Del Torto
authors.forename: Manuela
authors.initials: M
authors.lastname: Nozzi
authors.forename: Concettina
authors.initials: C
authors.lastname: Elio
authors.forename: Luciana
authors.initials: L
authors.lastname: Breda
authors.forename: Francesco
authors.initials: F
authors.lastname: Chiarelli
mesh_terms: D020434:Abducens Nerve Diseases / Q000150:complications* / Q000188:drug therapy*; D000284:Administration, Oral; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use; D002675:Child, Preschool; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D010033:Otitis Media / Q000150:complications* / Q000188:drug therapy*; D010243:Paralysis / Q000150:complications / Q000188:drug therapy*; D012851:Sinus Thrombosis, Intracranial / Q000150:complications* / Q000188:drug therapy*; D013577:Syndrome; D020433:Trigeminal Nerve Diseases / Q000150:complications* / Q000188:drug therapy*
chemical_list: D000900:Anti-Bacterial Agents; D000925:Anticoagulants
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