Pradeep Pradhan*, Abhishek Bhardwaj and Ashish Vashishth
Abstract:
Objective: To discuss the management and outcome of abducent nerve palsy in patients of apical petrositis associated with otitis media.
Results: Three cases of abducent nerve palsy with petrositis have been reported. Computed tomography (CT) scan of temporal bone demonstrated soft tissue opacification and expansion of mastoid and petrous air cells without bone erosion. Two patients recovered completely from diplopia by medical management and one underwent transcanal infracochlear hypotympanic approach for drainage of petrous apex because it did not respond to medical treatment. All patients had complete resolution of sixth nerve palsy.
Conclusion: With advancement of antibiotics, medical treatment should be initially offered to all patients of petrositis. Surgical intervention is reserved for patients, not responding to medical management. Transcanal infracochlear hypotympanic approach is an effective and safe method for drainage of petrous apex with complete recovery of sixth nerve with hearing preservation.
Objective: To discuss the management and outcome of abducent nerve palsy in patients of apical petrositis associated with otitis media.
Results: Three cases of abducent nerve palsy with petrositis have been reported. Computed tomography (CT) scan of temporal bone demonstrated soft tissue opacification and expansion of mastoid and petrous air cells without bone erosion. Two patients recovered completely from diplopia by medical management and one underwent transcanal infracochlear hypotympanic approach for drainage of petrous apex because it did not respond to medical treatment. All patients had complete resolution of sixth nerve palsy.
Conclusion: With advancement of antibiotics, medical treatment should be initially offered to all patients of petrositis. Surgical intervention is reserved for patients, not responding to medical management. Transcanal infracochlear hypotympanic approach is an effective and safe method for drainage of petrous apex with complete recovery of sixth nerve with hearing preservation.
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