Petrous Apicitis Research Articles

Bilateral sequential petrous apicitis secondary to an anaerobic bacterium

Bilateral sequential petrous apicitis secondary to an anaerobic bacterium

Nasopharyngeal Abscess and Facial Paralysis as Complications of Petrous Apicitis: A Case Report

An 83-year-old man with a lifelong history of intermittent otorrhea and hearing loss was referred for management of a facial paralysis of 3 weeks' duration. Computed tomography (CT) of the head detected a neoplasm of the nasopharynx along with chronic otomastoiditis. A followup CT suggested the development of a nasopharyngeal abscess, which was confirmed by needle aspiration. A later coronal-projection CT showed definite bone destruction in the anterior petrous apex, confirming suspicions that a petrous apicitis was responsible for the facial paralysis and abscess. This article describes the management of this patient and reviews the historical, medical, and surgical aspects of petrous apicitis.

Venous channels of the petrous apex: their presence and clinical importance.

A methyl methacrylate casting technique was used to make detailed casts of the intracerebral venous system of four human cadaver specimens. Seven of the eight petrous apices studied were diploeic (n = 5), or pneumatic (n = 2) and had venules coursing in the anterior petrous apex. These venules form conduits connecting the cavernous to the inferior petrosal sinus or the jugular bulb and have not been previously described. In addition to the air cell system of the petrous apex, these venules may represent pathways for the spread of infection and the development of petrous apicitis, Gradenigo's syndrome, and the rare otogenic cavernous sinus thrombophlebitis. Their presence also may help explain the location of cholesterol granulomas, which afflict this area of the skull base.

Venous channels of the petrous apex: Their presence and clinical

A methyl methacrylate casting technique was used to make detailed casts of the intracerebral venous system of four human cadaver specimens. Seven of the eight petrous apices studied were diploeic (n = 5), or pneumatic (n = 2) and had venules coursing in the anterior petrous apex. These venules form conduits connecting the cavernous to the inferior petrosal sinus or the jugular bulb and have not been previously described. In addition to the air cell system of the petrous apex, these venules may represent pathways for the spread of infection and the development of petrous apicitis, Gradenigo’s syndrome, and the rare otogenic cavernous sinus thrombophlebitis. Their presence also may help explain the location of cholesterol granulomas, which afflict this area of the skull base. (Otolaryngol Head Neck Surg 1997;116:168-74.)

Suppurative petrous apicitis: Osteitis or osteomyelitis? An imaging case report

(Editorial Comment: Modern imaging techniques suggest that petrous apicitis develops from direct extension of acute purulent otitis media into a pneumatized petrous apex.) Although recognition and treatment of suppurative petrous apicitis was discussed in the otologic literature early in the century, it was the decade of the 1930s that saw the great controversies concerning the pathophysiology and operative treatment of this once frequently fatal disease process. Vigorous discussions began in 1931 with the publication of Eagleton’s Unlocking of the Petrous Pyramid for Localized Bulbar (Pontile) Meningitis Secondary to Suppuration of the Petrous Apex.l In this landmark manuscript, Eagleton proposed that unlike mastoiditis, suppuration in the petrous apex was caused by a true osteomyelitis. Although many agreed with Eagleton, others argued that acute petrous apicitis was a result of coalescent osteitis within the pneumatized spaces of the petrous apex. Perhaps the most vocal advocate of osteitis of the petrous air cells as the underlying disease process in petrous apicitis was Julius Lempert.2 With the development of antibiotics, the great controversies concerning petrous apicitis quietly disappeared. The pathogenesis argument of osteomyelitis versus osteitis was never resolved. A recent patient with suppurative petrous apici

Petrous Apicitis: Evaluation by Bone SPECT and Magnetic Resonance Imaging

A case of petrous apicitis, an unusual inflammation of the petrous apex air cells, is reported. SPECT revealed the focal bony involvement, and these findings correlated well with the anatomical abnormalities seen on MRI.