Cases reported "Osteitis"

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1/4. abducens nerve palsy as the sole presenting symptom of petrous apicitis.

    Petrous apicitis as a potentially fatal complication of suppurative otitis media presents in a variety of forms. Gradenigo's triad of abducens paralysis, deep facial pain due to trigeminal involvement and acute suppurative otitis media rarely occurs. The conflicting symptoms reported in the literature usually result in the delayed recognition of the condition with potentially disastrous consequences. The VIth nerve palsy is considered to be the least reliable sign as it is least often present. We present a case in which it was the sole presenting symptom.
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ranking = 1
keywords = otitis
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2/4. petrositis and cerebellar abscess complicating chronic otitis media.

    A 12-year-old girl with chronic otitis media complicated by petrositis and cerebellar abscess is presented. Early surgical intervention, in combination with broad-spectrum antibiotics, provided a good outcome. life-threatening complications of otitis media, although rare, still occur in developed countries.
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ranking = 3
keywords = otitis
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3/4. Nonspecific necrotizing petrositis: an unusual complication of otitis in children.

    Three cases of an unusual form of suppurative chronic otitis media in children 2 and 3 years old are presented. The clinical feature common to all cases was otorrhea, beginning at the first months of life, with a silent evolution to a complete peripheral facial paralysis. In one case the facial paralysis was bilateral. The treatment applied was surgical: subtotal petrosectomy. The surgical findings were bloody granulation tissue, sequestering completely the otic capsule. The facial nerve was destroyed almost the total length of the Fallopian canal in all cases. The histopathologic examination revealed a destructive and nonspecific chronic inflammatory process. The culture showed Gram-negative organisms, such as pseudomonas aeruginosa and proteus mirabilis. Etiologic aspects involved in the process are discussed and the name non-specific necrotizing petrositis is suggested to individualize this rare form of otitis which, with morbidity, leads to severe complications such as facial paralysis and deafness.
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ranking = 3
keywords = otitis
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4/4. Benign necrotizing osteitis of the external auditory meatus.

    Benign necrotizing osteitis of the external auditory meatus is a rare condition which occurs in non-diabetic healthy people. The aetiology of the necrotic process with the formation of sequestrum in the bony external meatus is unknown. It is important to differentiate this benign process from malignant otitis externa and radionecrosis of the temporal bone as the management of these conditions differs. We present two cases, one managed surgically and the other medically, and review the literature. Immediate surgical excision of the sequestrum is advocated instead of long-term medical therapy and waiting for it to separate spontaneously.
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ranking = 0.5
keywords = otitis
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