title: When can lateral sinus thrombosis be treated conservatively?
abstract: OBJECTIVE
  The purpose of this study was to review the clinical manifestations, radiologic findings, and treatment modalities of our cases with lateral sinus thrombosis (LST).
  
  
  METHODS
  Documents of patients with LST, diagnosed and treated from 1995 to 2001 in our clinic, were examined retrospectively.
  
  
  RESULTS
  Four patients with the diagnosis of LST were treated during this period. Among the clinical manifestations of these patients, the most frequently encountered symptoms were earache and headache, in addition to otorrhea and hearing loss. Four cases had chronic otitis media, three with cholesteatoma and one with polyps. Delta sign was detected in three cases on computed tomography, whereas a suspicious image was noted in one case. This case underwent magnetic resonance angiography, and the diagnosis of LST was established conclusively. In two cases, because pus was aspirated via lateral sinus punctures performed intraoperatively, these sinuses were explored and obliterated following radical mastoidectomy. Because pus was not aspirated via punctures of the other two cases, their sinuses were not explored. Only radical mastoidectomy was performed surgically for these cases. Dual antibiotics and low-dose anticoagulant therapy were given concomitantly to all cases in the postoperative period. Recanalizations of the nonobliterated lateral sinuses were detected with Doppler ultrasonography of internal jugular vena at 15 days and 3 months after the termination of postoperative treatment.
  
  
  CONCLUSIONS
  Clinical findings and radiologic techniques play an important role in the diagnosis of LST. In the treatment, if pus is found in the lateral sinuses, it is necessary to explore, clean, and obliterate them, whereas in cases in which the aspirates do not contain pus, mastoidectomy is sufficient. On the other hand, a low dose of anticoagulant can be used together with antibiotics in the nonobliterated lateral sinuses.
authors.affiliation: Department of Otorhinolaryngology, Yüzüncü Yil University, School of Medicine, Van, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Kutluhan
authors.forename: Muzaffer
authors.initials: M
authors.lastname: Kiriş
authors.forename: Veysel
authors.initials: V
authors.lastname: Yurttaş
authors.forename: Ahmet Faruk
authors.initials: AF
authors.lastname: Kiroğlu
authors.forename: Ozkan
authors.initials: O
authors.lastname: Unal
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002908:Chronic Disease; D005260:Female; D006801:Humans; D020227:Lateral Sinus Thrombosis / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery*; D008297:Male; D010033:Otitis Media / Q000150:complications; D012189:Retrospective Studies; D016896:Treatment Outcome