The authors report four cases of Gradenigo syndrome (GS) with patients aged five to 70 years; three with classic acute presentation and one with presentation of chronic suppurative otitis media, cholesteatoma and sixth nerve palsy. The authors discuss anatomy, neuroimaging, acute versus chronic GS, conventional treatment and radical surgery. They conclude that GS is rare but constitutes a serious and life-threatening complication to acute otitis media. 

The forgotten syndrome? Four cases of Gradenigo syndrome and a review of the literature.
Jensen PVF, Hansen MS, Moller MN, Saunte JP.
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Fiona Rowe (Prof)

Institute of Population Health, University of Liverpool, UK.

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