Abstract

Case Report

Otogenic lateral sinus Thrombosis: a rare complication of chronic Otitis media

Eghoihunu Ireo*, Prashant Gupta and Ganapathy Dhanasekar

Published: 22 August, 2017 | Volume 1 - Issue 1 | Pages: 046-052

Since the advent of antibiotics, lateral sinus thrombosis is an infrequent complication of otitis media. Lateral sinus thrombosis may occur by thrombophlebitis or penetration by offending pathogens through the dura of middle and posterior cranial fossae. We present a case of right-sided sigmoid and transverse venous sinus thrombosis as a rare complication of chronic suppurative otitis media in an adult. We discuss the patient’s imaging, management and relevant literature to offer clinical recommendations.

A 39-year-old woman presented with headache, neck pain, vomiting, fever and photophobia with a tender right mastoid on examination. Computerised Tomography, Magnetic Resonance Imaging and Magnetic Resonance Venogram of the head revealed complete opacification of the right mastoid air cells and middle ear, with absent flow void in the right transverse and sigmoid sinus, consistent with thrombosis. After discussion with neurosurgery, she was commenced on anticoagulants. The patient was readmitted with right otalgia and otorrhea refractory to medical treatment, and ultimately underwent right mastoid exploration.

Conclusion: Lateral sinus thrombosis may occur with other intracranial or extracranial complications of otitis media. Clinicians should approach any complication of otitis media with vigilance as antibiotics may mask some signs and symptoms of mastoiditis, which can progress to otogenic brain abscess.

Read Full Article HTML DOI: 10.29328/journal.hor.1001009 Cite this Article Read Full Article PDF

Keywords:

Lateral sinus thrombosis; Chronic suppurative otitis media, Mastoiditis

References

  1. Au JK, Adam SI, Michaelides EM. Contemporary management of pediatric lateral sinus thrombosis: a twenty year review. Am J Otolaryngol. 2013; 34: 145-150. Ref.: https://goo.gl/TUPPjj
  2. Goldenberg RA. Lateral sinus thrombosis: Medical or surgical treatment? Arch Otolaryngol. 1985; 111: 56-58. Ref.: https://goo.gl/FBy7M5
  3. Lee JH, Choi SJ, Park K, Choung YH. Managements for lateral sinus thrombosis: does it need the ligation of internal jugular vein or anticoagulants? Eur Arch Otorhinolaryngol. 2009; 266: 51-58. Ref.: https://goo.gl/jYFbYa
  4. Christensen N, Wayman J, Spencer J. Lateral sinus thrombosis: a review of seven cases and proposal of a management algorithm. Int j pedia otorhinolaryngol. 2009; 73: 581-584. Ref.: https://goo.gl/zovEQk
  5. Ropposch T, Nemetz U, Braun EM, Lackner A, Tomazic PV, et al. Management of otogenic sigmoid sinus thrombosis. Otol Neurotol. 2011; 32: 1120-1123. Ref.: https://goo.gl/Jem88B
  6. Iseri M, Aydn Ö, Üstündag E, Keskin G, Almaç A. Management of lateral sinus thrombosis in chronic otitis media. Otol Neurotol. 2006; 27: 1098-1103. Ref.: https://goo.gl/7bk4ar

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