title: Therapeutic approach to Gradenigo's syndrome: a case report.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
authors.affiliation: Department of Otolaryngology, Tzanion General Hospital, Piraeus, Greece. dbalats@hotmail.com.
authors.forename: Ilias
authors.initials: I
authors.lastname: Kantas
authors.forename: Anna
authors.initials: A
authors.lastname: Papadopoulou
authors.forename: Dimitrios G
authors.initials: DG
authors.lastname: Balatsouras
authors.forename: Andreas
authors.initials: A
authors.lastname: Aspris
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Marangos