Gradenigo’s syndrome occurs in otitis media as infection extends to the apex of the petrous temporal bone. It also can occur as a result of hematogenous spread of bacteria or penetrating trauma.
Triad of clinical findings:
(1) unilateral periorbital pain (due to involvement of trigeminal nerve)
(2) sixth nerve palsy with diplopia (due to compression of abducens nerve in Dorello’s canal)
(3) otorrhea
where:
• Dorello’s canal is bordered by the petrosphenoidal ligament (superior/posterior), clivus (medial), and anteriomedial sphenoid ridge (lateral).
Complications:
(1) cranial osteomyelitis
(2) meningitis
(3) sepsis
(4) death
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