A 7-year-old girl with long-standing left-sided ear discharge develops severe retro-orbital pain and double vision. Examination shows inability to abduct the left eye, with the eye deviated medially. Temperature is mildly elevated. Which complication of CSOM has occurred?

• A Otitic hydrocephalus
• B Cerebellar abscess
• C Lateral sinus thrombophlebitis
• D Petrous apicitis (petrositis) ✓

Explanation

The triad of otorrhoea, retro-orbital pain, and ipsilateral sixth nerve palsy is Gradenigo's syndrome, caused by extension of infection to the petrous apex where the abducens nerve passes over the petrous tip near Dorello's canal. Lateral sinus thrombosis produces picket-fence fever and Griesinger's sign rather than ocular palsy. Cerebellar abscess causes ataxia and nystagmus. Otitic hydrocephalus presents with raised intracranial pressure without focal cranial nerve signs.

Reference: Scott-Brown's Otorhinolaryngology and Head and Neck Surgery, 8th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.