Extension of otomastoiditis (OM) into pneumatized petrous apex (PA), resulting in suppurative apical petrositis
IMAGING
General Features
CT Findings
MR Findings
Nuclear Medicine Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Chengazi HV et al: Emergency radiologic approach to mastoid air cell fluid. Emerg Radiol. 28(3):633-40, 2021
McLaren J et al: How well do we know Gradenigo? A comprehensive literature review and proposal for novel diagnostic categories of Gradenigo's syndrome. Int J Pediatr Otorhinolaryngol. 132:109942, 2020
Campion T et al: Imaging of temporal bone inflammations in children: a pictorial review. Neuroradiology. 61(9):959-70, 2019
Gadre AK et al: The changing face of petrous apicitis-a 40-year experience. Laryngoscope. 128(1):195-201, 2018
Choi KY et al: Petrositis with bilateral abducens nerve palsies complicated by acute otitis media. Clin Exp Otorhinolaryngol. 7(1):59-62, 2014
Kong SK et al: Acute otitis media-induced petrous apicitis presenting as the Gradenigo syndrome: successfully treated by ventilation tube insertion. Am J Otolaryngol. 32(5):445-7, 2011
Ibrahim M et al: Diffusion-weighted MRI identifies petrous apex abscess in Gradenigo syndrome. J Neuroophthalmol. 30(1):34-6, 2010
Lemmerling MM et al: Imaging of inflammatory and infectious diseases in the temporal bone. Neuroimaging Clin N Am. 19(3):321-37, 2009
Connor SE et al: Imaging of the petrous apex: a pictorial review. Br J Radiol. 81(965):427-35, 2008
Fournier HD et al: Surgical anatomy of the petrous apex and petroclival region. Adv Tech Stand Neurosurg. 32:91-146, 2007
Koral K et al: Petrous apicitis in a child: computed tomography and magnetic resonance imaging findings. Clin Imaging. 30(2):137-9, 2006
Lee YH et al: CT, MRI and gallium SPECT in the diagnosis and treatment of petrous apicitis presenting as multiple cranial neuropathies. Br J Radiol. 78(934):948-51, 2005
Park SN et al: Cavernous sinus thrombophlebitis secondary to petrous apicitis: a case report. Otolaryngol Head Neck Surg. 128(2): 284-6, 2003
Mathew L et al: Gradenigo's syndrome: findings on computed tomography and magnetic resonance imaging. J Postgrad Med. 48(4): 314-6, 2002
Price T et al: Abducens nerve palsy as the sole presenting symptom of petrous apicitis. J Laryngol Otol. 116(9): 726-9, 2002
Somers TJ et al: Chronic petrous apicitis with pericarotid extension into the neck in a child. Ann Otol Rhinol Laryngol. 110(10): 988-91, 2001
Dave AV et al: Clinical and magnetic resonance imaging features of Gradenigo syndrome. Am J Ophthalmol. 124(4): 568-70, 1997
Murakami T et al: Gradenigo's syndrome: CT and MRI findings. Pediatr Radiol. 26(9): 684-5, 1996
Hardjasudarma M et al: Magnetic resonance imaging features of Gradenigo's syndrome. Am J Otolaryngol. 16(4): 247-50, 1995
Tutuncuoglu S et al: Gradenigo syndrome: a case report. Pediatr Radiol. 23(7):556, 1993
Frates MC et al: Petrous apicitis: evaluation by bone SPECT and magnetic resonance imaging. Clin Nucl Med. 15(5): 293-4, 1990
Contrucci RB et al: Petrous apicitis. Ear Nose Throat J. 64(9): 427-31, 1985
Kearns DB et al: Tuberculous petrous apicitis. Arch Otolaryngol. 111(6): 406-8, 1985
Chole RA et al: Petrous apicitis. Clinical considerations. Ann Otol Rhinol Laryngol. 92(6 Pt 1): 544-51, 1983
Allam AF et al: Pathology of petrositis. Laryngoscope. 78(11):1813-32, 1968
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Clinical Issues
TERMINOLOGY
Synonyms
Petrous apicitis, confluent apical petrositis
Definitions
Extension of otomastoiditis (OM) into pneumatized petrous apex (PA), resulting in suppurative apical petrositis
IMAGING
General Features
CT Findings
MR Findings
Nuclear Medicine Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Chengazi HV et al: Emergency radiologic approach to mastoid air cell fluid. Emerg Radiol. 28(3):633-40, 2021
McLaren J et al: How well do we know Gradenigo? A comprehensive literature review and proposal for novel diagnostic categories of Gradenigo's syndrome. Int J Pediatr Otorhinolaryngol. 132:109942, 2020
Campion T et al: Imaging of temporal bone inflammations in children: a pictorial review. Neuroradiology. 61(9):959-70, 2019
Gadre AK et al: The changing face of petrous apicitis-a 40-year experience. Laryngoscope. 128(1):195-201, 2018
Choi KY et al: Petrositis with bilateral abducens nerve palsies complicated by acute otitis media. Clin Exp Otorhinolaryngol. 7(1):59-62, 2014
Kong SK et al: Acute otitis media-induced petrous apicitis presenting as the Gradenigo syndrome: successfully treated by ventilation tube insertion. Am J Otolaryngol. 32(5):445-7, 2011
Ibrahim M et al: Diffusion-weighted MRI identifies petrous apex abscess in Gradenigo syndrome. J Neuroophthalmol. 30(1):34-6, 2010
Lemmerling MM et al: Imaging of inflammatory and infectious diseases in the temporal bone. Neuroimaging Clin N Am. 19(3):321-37, 2009
Connor SE et al: Imaging of the petrous apex: a pictorial review. Br J Radiol. 81(965):427-35, 2008
Fournier HD et al: Surgical anatomy of the petrous apex and petroclival region. Adv Tech Stand Neurosurg. 32:91-146, 2007
Koral K et al: Petrous apicitis in a child: computed tomography and magnetic resonance imaging findings. Clin Imaging. 30(2):137-9, 2006
Lee YH et al: CT, MRI and gallium SPECT in the diagnosis and treatment of petrous apicitis presenting as multiple cranial neuropathies. Br J Radiol. 78(934):948-51, 2005
Park SN et al: Cavernous sinus thrombophlebitis secondary to petrous apicitis: a case report. Otolaryngol Head Neck Surg. 128(2): 284-6, 2003
Mathew L et al: Gradenigo's syndrome: findings on computed tomography and magnetic resonance imaging. J Postgrad Med. 48(4): 314-6, 2002
Price T et al: Abducens nerve palsy as the sole presenting symptom of petrous apicitis. J Laryngol Otol. 116(9): 726-9, 2002
Somers TJ et al: Chronic petrous apicitis with pericarotid extension into the neck in a child. Ann Otol Rhinol Laryngol. 110(10): 988-91, 2001
Dave AV et al: Clinical and magnetic resonance imaging features of Gradenigo syndrome. Am J Ophthalmol. 124(4): 568-70, 1997
Murakami T et al: Gradenigo's syndrome: CT and MRI findings. Pediatr Radiol. 26(9): 684-5, 1996
Hardjasudarma M et al: Magnetic resonance imaging features of Gradenigo's syndrome. Am J Otolaryngol. 16(4): 247-50, 1995
Tutuncuoglu S et al: Gradenigo syndrome: a case report. Pediatr Radiol. 23(7):556, 1993
Frates MC et al: Petrous apicitis: evaluation by bone SPECT and magnetic resonance imaging. Clin Nucl Med. 15(5): 293-4, 1990