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CC BY-NC-ND 4.0 · Int Arch Otorhinolaryngol 2018; 22(03): 208-213
DOI: 10.1055/s-0037-1604198
Original Research
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Otogenic Lateral Sinus Thrombosis: A Review of Fifteen Patients and Changing Trends in the Management

Kalaiarasi Raja
1   Department of ENT, Sri Lakshmi Narayana Institute of Medical Sciences, Pondicherry, Puducherry, India
,
Pradipta Kumar Parida
2   Department of ENT, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
,
Arun Alexander
3   Department of ENT, Jawaharlal Institute of Post-Graduate Medical Education, Pondicherry, Puducherry, India
,
Gopalakrishnan Surianarayanan
4   Department of ENT, Mahatma Gandhi Medical College and Research Institute, Pondicherry, Puducherry, India
› Author Affiliations
Further Information

Publication History

12 April 2017

04 June 2017

Publication Date:
14 July 2017 (online)

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Abstract

Introduction Otogenic lateral sinus thrombosis is a rare intracranial complication of otitis media in the modern age of antibiotic treatment, but it is potentially a dangerous complication.

Objectives The aim of this study is to focus on the various clinical presentations, management options and sequelae in a series of fifteen patients with otogenic lateral sinus thrombosis.

Methods Retrospective chart review of inpatients treated for otogenic lateral sinus thrombosis at our tertiary care institution between 2010 and 2015.

Results A total of 15 patients (11 males and 4 females) with ages ranging from 9 to 60 years were diagnosed with otogenic lateral sinus thrombosis. The most commonly reported symptoms were headache, ear discharge and hard of hearing, which were experienced by all 15 (100%) patients. In contrast to previous studies found in the literature, 7 (47%) patients in our series presented with neck pain and neck abscess. Imaging studies and microbiological cultures were performed for all patients, who also underwent a mastoidectomy procedure. Internal jugular vein ligation was performed on 5 (33%) patients. Incision and drainage of the neck abscess was performed on 7 (47%) patients. All patients had a satisfactory resolution of their symptoms, and the mortality rate was of 0%.

Conclusions Otogenic lateral sinus thrombosis, though a rare complication, can still occur; therefore, keeping a high level of suspicion is important, especially in developing countries. We also describe the patients with neck abscess associated with this rare condition. Combining parenteral antibiotics with surgical intervention is the treatment of choice.

Keywords

lateral sinus thrombosis - otitis media - cholesteatoma
 

  • References

  • 1 Kangsanarak J, Fooanant S, Ruckphaopunt K, Navacharoen N, Teotrakul S. Extracranial and intracranial complications of suppurative otitis media. Report of 102 cases. J Laryngol Otol 1993; 107 (11) 999-1004
    CrossrefPubMedGoogle Scholar
  • 2 Garcia RD, Baker AS, Cunningham MJ, Weber AL. Lateral sinus thrombosis associated with otitis media and mastoiditis in children. Pediatr Infect Dis J 1995; 14 (07) 617-623
    CrossrefPubMedGoogle Scholar
  • 3 Smith JA, Danner CJ. Complications of chronic otitis media and cholesteatoma. Otolaryngol Clin North Am 2006; 39 (06) 1237-1255
    CrossrefPubMedGoogle Scholar
  • 4 Ooi EH, Hilton M, Hunter G. Management of lateral sinus thrombosis: update and literature review. J Laryngol Otol 2003; 117 (12) 932-939
    CrossrefPubMedGoogle Scholar
  • 5 Christensen N, Wayman J, Spencer J. Lateral sinus thrombosis: a review of seven cases and proposal of a management algorithm. Int J Pediatr Otorhinolaryngol 2009; 73 (04) 581-584
    CrossrefPubMedGoogle Scholar
  • 6 Ghosh PS, Ghosh D, Goldfarb J, Sabella C. Lateral sinus thrombosis associated with mastoiditis and otitis media in children: a retrospective chart review and review of the literature. J Child Neurol 2011; 26 (08) 1000-1004
    CrossrefPubMedGoogle Scholar
  • 7 Bales CB, Sobol S, Wetmore R, Elden LM. Lateral sinus thrombosis as a complication of otitis media: 10-year experience at the children's hospital of Philadelphia. Pediatrics 2009; 123 (02) 709-713
    CrossrefPubMedGoogle Scholar
  • 8 de Oliveira Penido N, Testa JR, Inoue DP, Cruz OL. Presentation, treatment, and clinical course of otogenic lateral sinus thrombosis. Acta Otolaryngol 2009; 129 (07) 729-734
    CrossrefPubMedGoogle Scholar
  • 9 Zanoletti E, Cazzador D, Faccioli C, Sari M, Bovo R, Martini A. Intracranial venous sinus thrombosis as a complication of otitis media in children: Critical review of diagnosis and management. Int J Pediatr Otorhinolaryngol 2015; 79 (12) 2398-2403
    CrossrefPubMedGoogle Scholar
  • 10 Ryan JT, Pena M, Zalzal GH, Preciado DA. Otogenic lateral sinus thrombosis in children: A review of 7 cases. Ear Nose Throat J 2016; 95 (03) 108-112
    PubMedGoogle Scholar
  • 11 Davison SP, Facer GW, McGough PF, McCaffrey TV, Reder PA. Use of magnetic resonance imaging and magnetic resonance angiography in diagnosis of sigmoid sinus thrombosis. Ear Nose Throat J 1997; 76 (07) 436-441
    CrossrefPubMedGoogle Scholar
  • 12 Iseri M, Aydin O, Ustündağ E, Keskin G, Almaç A. Management of lateral sinus thrombosis in chronic otitis media. Otol Neurotol 2006; 27 (08) 1098-1103
    CrossrefPubMedGoogle Scholar
  • 13 Kelly KE, Jackler RK, Dillon WP. Diagnosis of septic sigmoid sinus thrombosis with magnetic resonance imaging. Otolaryngol Head Neck Surg 1991; 105 (04) 617-624
    CrossrefPubMedGoogle Scholar
  • 14 Magliulo G, Terranova G, Cristofari P, Ronzoni R. Sigmoid sinus thrombosis and imaging techniques. Ann Otol Rhinol Laryngol 1996; 105 (12) 991-993
    CrossrefPubMedGoogle Scholar
  • 15 Seven H, Ozbal AE, Turgut S. Management of otogenic lateral sinus thrombosis. Am J Otolaryngol 2004; 25 (05) 329-333
    CrossrefPubMedGoogle Scholar
  • 16 Syms MJ, Tsai PD, Holtel MR. Management of lateral sinus thrombosis. Laryngoscope 1999; 109 (10) 1616-1620
    CrossrefPubMedGoogle Scholar
  • 17 Kutluhan A, Kiriş M, Yurttaş V, Kiroğlu AF, Unal O. When can lateral sinus thrombosis be treated conservatively?. J Otolaryngol 2004; 33 (02) 107-110
    CrossrefPubMedGoogle Scholar
  • 18 Tov EE, Leiberman A, Shelef I, Kaplan DM. Conservative nonsurgical treatment of a child with otogenic lateral sinus thrombosis. Am J Otolaryngol 2008; 29 (02) 138-141
    CrossrefPubMedGoogle Scholar
  • 19 Neilan RE, Isaacson B, Kutz Jr JW, Lee KH, Roland PS. Pediatric otogenic lateral sinus thrombosis recanalization. Int J Pediatr Otorhinolaryngol 2011; 75 (06) 850-853
    CrossrefPubMedGoogle Scholar
  • 20 Au JK, Adam SI, Michaelides EM. Contemporary management of pediatric lateral sinus thrombosis: a twenty year review. Am J Otolaryngol 2013; 34 (02) 145-150
    CrossrefPubMedGoogle Scholar
  • 21 Meltzer PE. Treatment of thrombosis of lateral sinus. Arch Otolaryngol 1935; 22: 131-142
    CrossrefGoogle Scholar
  • 22 Vijayashree MS, Viswanatha B. Otological manifestations of nonseptic lateral sinus thrombosis:A Review. Indian J Otolaryngol Head Neck Surg 2016; 68 (04) 400-405
    CrossrefPubMedGoogle Scholar
  • 23 Wong BY, Hickman S, Richards M, Jassar P, Wilson T. Management of paediatric otogenic cerebral venous sinus thrombosis: a systematic review. Clin Otolaryngol 2015; 40 (06) 704-714
    CrossrefPubMedGoogle Scholar