Gradenigo’s syndrome

NEET PG DailyMCQs
#1

1.Gradenigo’s syndrome is characterized by the following, EXCEPT:

Abducens nerve palsy
Retro-orbital pain
Persistent ear discharge
Facial nerve palsy

GRADENIGO’S SYNDROME

  • Gradenigo’s syndrome is characterized by pain in the face (from irritation of the trigeminal nerve) and abducens palsy.

  • The syndrome is produced by disease of the tip of the petrous bone and most often occurs as a rare complication of otitis media with mastoiditis or petrous bone tumors.

Organs Involved:

  • Petrous temporal bone

  • Sixth cranial nerve

Diagnostic Characteristics:

  • Otitis media and mastoiditis involving petrous apex bone

  • Cranial nerve lateral gaze palsy

  • Retro-orbital pain

Associated Abnormalities:

  • Bell’s palsy. When VIIth nerve also involved

  • Excessive lacrimation

  • Reduced corneal sensitivity
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2.Which of the following is not true about the pleomorphic adenoma of parotid gland?

Facial nerve involvement indicate malignancy
It occurs most commonly in parotid gland
Malignant disease is most common variety
Superficial parotidectomy is the treatment of choice
The ratio of malignant to benign tumors by the as well: parotid gland, 80% benign and 20% malignant; Submandibular gland and sublingual gland, 50% benign and 50% malignant; and minor salivary glands, 25% benign and 75% malignant.

Facial nerve palsy is an infrequent presenting complaint and indicate malignancy.

Pleomorphic adenoma (mixed tumor):

This is the commonest tumor of the major salivary gland and its marked feature id histological diversity. It is called mixed because beside epithelial element there is also myxoid, hyline, chondroid (cartilaginous) and even osseous bone.

About 90% of pleomorphic adenoma is seen in parotid gland ,7% is seen in submandibular gland. tail of the parotid is commonest location in the tail of parotid.

Nature of tumor:

It is basically a benign tumor. Recurrence rate, which is reported to be high, was mostly due to fault in the surgical technique in the form of simple enucleation which was often used earlier. The incidence of malignant transformation increases with the duration of the tumor, being 2% for tumors present with less than 5 years duration and 10% for those of more than 15 years duration.

Treatment:

This tumor is radioresistant, so excision is treatment of choice. Superficial parotidectomy is the treatment of choice, this operation is known as patey’s operation. In case of submandibular gland neoplasm, the whole gland is excised with particular care to preserve the lingual and hypoglossal nerve.

Reference: L&B 25/e, page 761-62; Sabiston 18/e, page 834-36 ; Robins 7/e, page 791-92; Textbook of surgery by S. Das 5/e, page 607-609.

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3.For which of the following ocular conditions tucking of inferior lid retractors is done?

Senile ectropion
Divergent squint
Ankyloblepharon
Ptosis

Senile ectropion:

Involutional ectropion usually develops as a result of laxity of the suspensory system of the lower eyelid, and the medial and lateral canthal ligaments, allowing the lid to fall away from the globe.

This laxity is accompanied by a horizontal lengthening of the lid.
In the presence of a complete ectropion, the lower retractors or the capsulopalpebral tissues need to be reattached.

Must know:

:diamonds: Ectropion is an outward turning of the lid margin.
:diamonds: It may be involutional, paralytic, cicatricial, mechanical or congenital.
:diamonds: Involutional ectropion is the result of horizontal eyelid laxity from aging.
:diamonds: Paralytic ectropion follows facial nerve palsy.
:diamonds: Cicatricial ectropion is caused by contracture of the skin of the lid from trauma or inflammation.
:diamonds: Mechanical ectropion usually occurs because of bulky tumors of the lid.

Reference: Parsons’ Diseases of the Eye By Ramanjit Sihota & Radhika Tandon, 21st edition, Page 449

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