Infections of the Temporal Bone

Question 1

Petrous Apicitis: Important Points

Answer 1

1) Rare in the antibiotic era
2) Triad of Symptoms (Gradenigo’s Syndrome):
- Otorrhea
- Retroorbital pain
- Diplopia caused by CN VI palsy
3) IV Antibiotics are the first line of therapy
4) Petrous apicectomy should be considered if infection does not improve or intracranial complications are suspected
5) If due to Chronic Otitis Media with cholesteatoma
- Give IV antibiotics first
- Surgical management of the cholesteatoma when acute infection resolved