Skull Base 2009; 19 - A180
DOI: 10.1055/s-2009-1222293

Lateral Sinus Thrombosis

Sabir Husin Athar Primuharsa Putra 1(presenter), Ami Mazita 1, Mat Baki Marina 1, Saim Lokman 1
  • 1Seremban and Kuala Lumpur, Malaysia

Introduction: Lateral sinus thrombosis is an infrequent complication of otitis media and mastoiditis in the antibiotic era. It accounts for approximately 10% of all cases of intracranial complications and about half of these are associated with other intracranial complications, usually cerebellar abscess or meningitis.

Case Report: We present an 11-year-old boy who had a 2-year history of intermittent right ear discharge. He presented with sudden right occipitofrontal headache associated with fever and vomiting. Clinical examination showed he had right mastoid tenderness and foul smelling yellowish mucoid discharge in the right external auditory canal with no view of the right tympanic membrane. There were no neurological deficits. Urgent CT scan of the brain and mastoid showed right lateral sinus thrombosis and mastoiditis.

Result: Microscopical examination showed a small central perforation of the tympanic membrane and granulation tissue at the superior aspect of the tympanic membrane. The patient underwent modified radical mastoidectomy, during which cholesteatoma and perisinus abscess were found. The sinus wall was intact, and the sinus flow was normal. Therefore, a diagnosis of chronic suppurative otitis media with cholesteatoma and perisinus abscess was made. He was discharged in good condition on the eighth postoperative day.

Conclusion: Lateral sinus thrombosis is still a dangerous condition that must be recognized as early as possible and treated vigorously.