A 23 year old patient has fever with chills and headache since 7-8 days. Patient gives history of purulent are discharge on and off. He has retro-orbital pain. On examination he has mild ptosis. What is the likely diagnosis?

GRADENIGO'S SYNDROME Petrositis is spread of infection from middle ear and mastoid to petrous pa of temporal bone. It is a complication of otitis media, which classically presents with a triad of symptoms, known as Gradenigo's syndrome characterized by: 1. Abducent nerve (Lateral rectus) palsy. 2. Deep- seated ear or retro-orbital pain (V nerve involvement) 3. Persistent ear discharge * However, fever, headache, vomiting and sometimes neck stiffness also occurs. * Stenver's (Stockholm C) and Towne's radiographic views for petrous apex and internal auditory meatii point towards diagnosis while HRCT of temporal bone is confirmatory and gives greater anatomical details. * Treatment these days is antibiotic therapy alone, but sometime mastoidectomy may be required.