Infralabrynthine approach as a conservative management of petrositis, our clinical experience in five patients

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Abstract

Introduction

Although apical petrositis has been typically managed with aggressive surgical intervention, the advent of antibiotics facilitated the conservative management of selected cases, however some resistant cases may still need conservative surgical intervention.

Objective

To present our experience with apical petrositis successfully treated via an infralabyrithine approach with the preservation of both middle and the inner ear after failure of aggressive medical treatment.

Methods

A retrospective study done by collecting the data of five patients with Gradenigo′s syndrome who underwent surgical drainage by the authors via an infralabrynthine approach. The aim of this approach was to preserve the cochleovestibular function instead of translabrynthine approach as the five patients had variable degrees of pure conductive deafness without any evidence of labrynthine affection.

Results

All patients started showing an improvement immediately after surgery, with the disappearance of diplopia and the lateral rectus palsy being the first outcome to be noted. In our series, only one patient developed mild vertigo and vomiting that lasted for 3 days, and was treated with sedation and antiemetics.

Conclusion

Infralabrynthine approach is a safe and direct way to drain inflammatory exudates from petrious apex.