title: Management of otogenic sigmoid sinus thrombosis.
abstract: OBJECTIVE
  To analyze the demographics, presenting symptoms, diagnosis, and management of otogenic sigmoid sinus thrombosis and to propose an algorithm in diagnosis and treatment.
  
  
  METHODS
  A retrospective chart review was performed. Six patients who were treated at the ENT University Hospital Graz between 2005 and 2010 were included.
  
  
  RESULTS
  The mean age of the patients was 11.7 years. Patients were experiencing symptoms for 9.8 days on average. Presenting symptoms were headache, neck stiffness, fever, otalgia, postauricular pain, and erythema. One patient presented with sixth nerve palsy. The otoscopic findings were abnormal in all cases. Computed tomography with contrast enhancement was performed in all patients. It was possible to detect the thrombosis in all cases with computed tomographic scans after contrast administration. An additional magnetic resonance imaging was performed in 3 patients. One patient was treated completely conservatively. All other patients underwent surgical treatment consisting of mastoidectomy. Additional thrombectomy was performed in 3 patients, and ligation of the internal jugular vein was performed in 2 of these 3 patients. All patients were administered intravenous antibiotics and anticoagulants. There were no complications related to the therapy. Recanalization was found in all patients who were treated without thrombectomy or ligation of the internal jugular vein and in the patient with complete conservative treatment.
  
  
  CONCLUSIONS
  Otogenic sigmoid sinus thrombosis is a rare complication of otitis media. Early treatment with broad-spectrum antibiotics combined with simple mastoidectomy is the standard treatment. Anticoagulants represent a safe treatment option if they are administered correctly.
authors.affiliation: Department of Neurootology, Medical University Graz, Graz, Austria. thorsten.ropposch@klinikumgraz.at
authors.forename: Thorsten
authors.initials: T
authors.lastname: Ropposch
authors.forename: Ulrike
authors.initials: U
authors.lastname: Nemetz
authors.forename: Eva Maria
authors.initials: EM
authors.lastname: Braun
authors.forename: Andreas
authors.initials: A
authors.lastname: Lackner
authors.forename: Peter Valentin
authors.initials: PV
authors.lastname: Tomazic
authors.forename: Christian
authors.initials: C
authors.lastname: Walch
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003392:Cranial Sinuses / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008416:Mastoid / Q000601:surgery*; D010033:Otitis Media / Q000150:complications*; D012189:Retrospective Studies; D012851:Sinus Thrombosis, Intracranial / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery*; D017131:Thrombectomy; D016896:Treatment Outcome