The medial portion of the petrous bone between the inner ear and clivus may become a site of persistent infection when the drainage of its pneumatic cell tracts becomes blocked This may cause foul discharge, deep ear and retro-orbital pain, and sixth nerve palsy (Gradenigo syndrome); meningitis may be a complication

Treatment

is with prolonged antibiotic therapy (based on culture results) and surgical drainage via petrous apicectomy