12/30/2025
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Petrous apex lesions in the pediatric population | Pediatric ...
Petrous apicitis (PA) is a rare, serious infection and inflammation of the petrous apex (the tip of the temporal bone in the skull base) often stemming from an ear infection (otitis media), causing deep headaches, facial pain, and sometimes nerve issues like double vision (abducens nerve palsy), though antibiotics have made it uncommon, requiring imaging (HRCT/MRI) for diagnosis and treatment with antibiotics, potentially surgery.
What it is
An infection or inflammation in the petrous apex, a dense bone at the skull’s base near the ear.
A complication of middle ear infection (acute otitis media) that spreads inward.
Symptoms
Deep, persistent headache (often in the eye/forehead).
Facial pain or numbness.
Double vision (diplopia) due to sixth cranial nerve palsy (abducens nerve).
Facial weakness or paralysis (seventh nerve).
Vertigo, hearing loss, ear pain.
