Atypical Gradenigo Syndrome in an Elderly Man Resolved with Mastoidectomy and Petrous Apicectomy

Azizullah Beran; Nameer Aladamat; Mustafa Alchalabi; Mohammed Mhanna; Omar Srour; Yasmin Khader; Ammar Kayyali

doi:10.12890/2022_003344

Atypical Gradenigo Syndrome in an Elderly Man Resolved with Mastoidectomy and Petrous Apicectomy

Eur J Case Rep Intern Med. 2022 Jul 19;9(7):003344. doi: 10.12890/2022_003344. eCollection 2022.

Authors

Azizullah Beran¹, Nameer Aladamat², Mustafa Alchalabi², Mohammed Mhanna¹, Omar Srour¹, Yasmin Khader¹, Ammar Kayyali¹

Affiliations

¹ Department of Internal Medicine, University of Toledo, Toledo, OH, USA.
² Department of Neurology, University of Toledo, Toledo, OH, USA.

Abstract

Gradenigo syndrome (GS) was described primarily in the paediatric population, especially in the pre-antibiotic era. GS is rarely reported in the elderly population, especially in the post-antibiotic era. We present the rare case of a 67-year-old man who presented with an incomplete triad of symptoms (without abducens nerve palsy) of GS that failed medical therapy and was successfully treated with surgical intervention (mastoidectomy and petrous apicectomy). Physicians should be familiar with atypical presenting symptoms of GS as it can lead to life-threatening complications, especially in the elderly. GS cases resistant to medical therapy may require prompt appropriate imaging studies and surgical intervention.

Learning points: Gradenigo syndrome may present with an incomplete triad (without abducens nerve palsy), especially in the post-antibiotic era.Gradenigo syndrome can rarely affect immunocompromised elderly patients.Gradenigo syndrome cases resistant to medical therapy may require prompt appropriate imaging studies and surgical intervention (mastoidectomy and petrous apicectomy).

Keywords: Gradenigo syndrome; abducens nerve palsy; elderly.