Sigmoid sinus thrombosis associated to chronic otitis media.
Otogenous lateral sinus thrombosis (OLST) is a rare disease and presents a controversial treatment.


OBJECTIVE
Clinical aspects and treatment were reported based on our experience.


METHODS
Retrospective study. Six cases of OLST were treated in our institution in the last ten years. Clinical and imaging data were analyzed.


RESULTS
All six patients had the lateral sinus thrombosis detected during image evaluation for other symptoms related to chronic otitis media (COM) complications. Fever, headache and facial paralysis were the main clinical manifestation related to mastoiditis, meningitis and cerebellar abscess. We could not identify, in any case, specific features of lateral sinus thrombosis. In all cases a mastoidectomy was associated with large spectrum antibiotics maintained for 3 months. In three cases anticoagulation therapy was introduced and in three cases anticoagulation was not indicated. All cases presented a good clinical evolution, without sequelae.


CONCLUSIONS
OLST is almost always associated with other complications of COM. It is diagnosed almost by accident during the investigative image study. We believe such disease is underestimated. In our experience, OLST presents a benign course, and mastoidectomy with antibiotics is the treatment of choice.
Penido
Norma de Oliveira
Nde O
UNIFESP-EPM. nopenido@terra.com.br
Toledo
Ronaldo Nunes
RN
Silveira
Paula Angélica Lorenzon
PA
Munhoz
Mario Sérgio Lei
MS
Testa
José Ricardo Gurgel
JR
Cruz
Oswaldo Laércio Mendonça
OL
D000293:Adolescent; D000328:Adult; D002648:Child; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008416:Mastoid / Q000601:surgery; D008875:Middle Aged; D010033:Otitis Media / Q000150:complications*; D012189:Retrospective Studies; D012851:Sinus Thrombosis, Intracranial / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome