Otogenic lateral sinus thrombosis: Case series and controversies

Jamie Lauren Funamura, Alexander T. Nguyen, Rodney C Diaz

Research output: Contribution to journalArticle

13 Scopus citations

Abstract

Objectives: The aim of this study is to (1) report the clinical presentation, treatment, and sequelae in a series of pediatric patients with otogenic lateral sinus thrombosis and (2) to review the most controversial aspects of management of this rare intracranial complication of otitis media. Methods: Retrospective chart review of inpatients treated for central venous thrombosis at a tertiary care facility between 1996 and 2012. Results: Five pediatric patients (four male, one female) were identified with otogenic lateral sinus thrombosis. Age at presentation ranged from 13 months to 15 years. All underwent a surgical procedure, ranging from a simple myringotomy with tympanostomy tube placement to tympanomastoidectomy and internal jugular vein ligation or craniotomy. Three were anticoagulated with unfractionated heparin with subsequent transition to low molecular weight heparin of variable duration. One patient developed a non-life-threatening intracranial hemorrhage while on long-term anticoagulation. Follow-up imaging, when available, did not directly correlate complete thrombus resolution with use of anticoagulation or with persistent symptoms. Conclusions: Otogenic lateral sinus thrombosis is a rare intracranial complication of otitis media with significantly reduced morbidity and mortality in the modern era of antibiotic treatment, surgical intervention, and anticoagulation therapy. Due to the rarity of this condition today, the recommended extent of surgical intervention and need for routine anticoagulation are unclear, and requires further data to determine definitively.

Original languageEnglish (US)
Pages (from-to)866-870
Number of pages5
JournalInternational Journal of Pediatric Otorhinolaryngology
Volume78
Issue number5
DOIs
StatePublished - 2014

Keywords

  • Acute otitis media
  • Anticoagulation
  • Complications
  • Intracranial
  • Lateral sinus thrombosis
  • Otomastoiditis

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Pediatrics, Perinatology, and Child Health
  • Medicine(all)

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