{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T18:33:21Z","timestamp":1790015601164,"version":"4.0.1"},"reference-count":86,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:00:00Z","timestamp":1756425600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Purpose: Gradenigo syndrome is a rare complication of acute otitis media (AOM) in children, characterized by suppurative otitis media, unilateral facial pain, and ipsilateral abducens nerve palsy. This review summarizes pediatric data on the presentation, diagnostics, treatment, and outcomes. Methods: A literature research was conducted using the terms \u201cGradenigo syndrome,\u201d \u201cpetrous apicitis,\u201d and \u201ccomplications otitis media.\u201d Pediatric cases were analyzed for demographics, symptoms, diagnostic findings, therapeutic strategies, and clinical outcomes. Results: Sixty-three articles described 65 patients (mean age: 8.0 years). The classic triad occurred in 22% of cases; 74% showed incomplete presentations. Imaging revealed petrous apex inflammation (84%) and petrous bone tip obliteration (49%). Antibiotics were administered in 88% of cases, most commonly third-generation cephalosporins. Surgery was performed in 72%, mainly myringotomy, tympanostomy tube insertion, and mastoidectomy; no direct petrous apex approaches were reported. Pathogens were identified in 41% of cases, most commonly Fusobacterium necrophorum. Clinical improvement occurred in 98%, with 75% achieving a complete resolution; complications were reported in 29%, including one fatality (2%). Conclusions: Given its variable presentation, comprehensive diagnostic imaging is essential for the diagnosis of Gradenigo syndrome. Early broad-spectrum antibiotic therapy is essential. Surgical intervention is required in severe cases. Long-term targeted antibiotic therapy may help prevent recurrence.<\/jats:p>","DOI":"10.3390\/diagnostics15172193","type":"journal-article","created":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T12:25:57Z","timestamp":1756470357000},"page":"2193","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Diagnosis, Management, and Outcomes of Gradenigo Syndrome in Children: A Scoping Review of the Literature"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-0741-0394","authenticated-orcid":false,"given":"Charles","family":"Schmit","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology-Head and Neck Surgery, Medical University of Innsbruck, 6020 Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8240-7255","authenticated-orcid":false,"given":"Felix","family":"Keller","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine IV (Nephrology and Hypertension), Medical University of Innsbruck, 6020 Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1022-6877","authenticated-orcid":false,"given":"Timo","family":"Gottfried","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology-Head and Neck Surgery, Medical University of Innsbruck, 6020 Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roland","family":"Hartl","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology-Head and Neck Surgery, Medical University of Innsbruck, 6020 Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lea","family":"Stecher","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology-Head and Neck Surgery, Medical University of Innsbruck, 6020 Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-0489-0508","authenticated-orcid":false,"given":"Andrea","family":"Tr\u00f6ger","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology-Head and Neck Surgery, Medical University of Innsbruck, 6020 Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Santer","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology-Head and Neck Surgery, Medical University of Innsbruck, 6020 Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veronika","family":"Innerhofer","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology-Head and Neck Surgery, Medical University of Innsbruck, 6020 Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Avneet","family":"Radhawa","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery, New York Presbyterian Hospital, New York, NY 10032, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5030-8132","authenticated-orcid":false,"given":"Joachim","family":"Schmutzhard","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology-Head and Neck Surgery, Medical University of Innsbruck, 6020 Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedikt","family":"Hofauer","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology-Head and Neck Surgery, Medical University of Innsbruck, 6020 Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annette","family":"Runge","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology-Head and Neck Surgery, Medical University of Innsbruck, 6020 Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e20170181","DOI":"10.1542\/peds.2017-0181","article-title":"Epidemiology of Acute Otitis Media in the Postpneumococcal Conjugate Vaccine Era","volume":"140","author":"Kaur","year":"2017","journal-title":"Pediatrics"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"32","DOI":"10.2174\/1874609810666170712145332","article-title":"Acute Otitis Media in Children","volume":"11","author":"Leung","year":"2017","journal-title":"Recent Pat. 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