A Case of Gradenigo’s Syndrome in an Elderly Patient

TL;DR

An elderly man with diabetes developed Gradenigo’s Syndrome after a dental infection, highlighting the rare but serious complications of untreated infections.

Contribution

This case emphasizes the clinical significance of Gradenigo’s Syndrome in the context of modern antibiotic use and diabetes.

Findings

GS can occur in elderly patients with diabetes following dental infections.

Imaging confirmed petrous apicitis as the underlying cause of GS in this case.

The case underscores the importance of prompt and responsible antibiotic treatment to prevent rare complications.

Abstract

Gradenigo's syndrome (GS) presents with the classical triad of otitis media, facial pain, and abducens nerve palsy as a complication of petrous apicitis. However, in the era of increased antibiotic use, complications of petrous apicitis have become infrequent and cases of GS are not frequently seen in clinical practice. We present the case of a 76-year-old man with uncontrolled diabetes mellitus presented with a two-month history of worsening right-sided headache, right-sided facial pain and weakness, along with dysphagia, hearing loss, and right otalgia with intermittent otorrhea following a right upper molar extraction. Imaging identified the inflammatory changes and indications of petrous apicitis. Although GS has become quite rare in recent years, this case highlights the importance of the responsible use of antibiotics in treating a seemingly innocuous infection.

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