Lateral Sinus Thrombosis: A Rare and Serious Complication of Chronic Otitis Media

Background and Aim: Lateral sinus thrombosis as a consequence of middle-ear disease is rarely seen, with the incidence having decreased substantially since the advent of antibiotics. Uncertainty, however, remains about how to best diagnose and treat the condition when it is suspected, and a lack of understanding of the principles of management may contribute to the continued significant mortality from the disease.

Case Reports: Two cases with lateral sinus thrombosis due to chronic cholesteatoma-associated otitis media are presented, and signs, diagnosis, and treatment of the disease are discussed. In both patients, the lateral sinus thrombosis was detected by imaging studies performed to evaluate complications and symptoms related to chronic otitis media. Fever and headache were the main clinical manifestations associated with coexisting mastoiditis, meningitis, and cerebellar and epidural abscess. Clinical features specific to lateral sinus thrombosis could not be identified in any case. Radical mastoidectomy in combination with broad-spectrum antibiotics and anticoagulation therapy provided effective treatment.

Conclusion: Computed tomography, magnetic resonance imaging, and angiography are the most helpful in determining the diagnosis, but the final diagnosis is made by surgical exploration. The prognosis of lateral sinus thrombosis is good if treatment is instituted early with broad-spectrum intravenous antibiotics and surgery.