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Clinical Problem Solving: Radiology
February 15, 2010

Radiology Quiz Case 2: Diagnosis

Author Affiliations


Arch Otolaryngol Head Neck Surg. 2010;136(2):203. doi:10.1001/archoto.2009.218-b

Gradenigo syndrome is a rare complication of otitis in which infection results in damage to the abducens and trigeminal nerves. The infection spreads from the middle ear to the petrous apex through pneumatization (33% of the general population1,2). Vascular channel or bone erosion can also play a role in propagating the infection.3Gradenigo syndrome develops 1 week to 3 months after the onset of otitis media.3,4The bacteria found in Gradenigo syndrome are the same as those implicated in acute otitis media and mastoiditis.5