title: [Lateral Sinus Thrombosis--A Rare Complication of an Acute Mastoiditis or Infected Cholesteatoma].
abstract: BACKGROUND
  Lateral sinus thrombosis (LST) is a rare but threatening complication of an acute mastoiditis or infected cholesteatoma. Currently only very few papers are available in the literature dealing with the systematic investigation of patients with suspected LST. The purpose of the present study was to evaluate the clinical, intraoperative and therapeutic findings of patients with particular disease.
  
  
  METHODS
  For this retrospective study the clinical records of 7 patients which were admitted for a suspected LST were evaluated. All patients underwent mastoidectomy with exposition of the lateral sinus and investigating of its blood flow.
  
  
  RESULTS
  A LST was confirmed in 4 patients, 3 patients had a phlebitis. Patients with a LST presented additional symptoms beside otalgia, i. e., dizziness, cephalgia, meningism, deafness of the affected ear, and facial nerve paresis. Postoperative MRI scans revealed a recanalization of the sinus in all cases. Although immediate surgery, 2 patients developed a 2-staged brain abscess in the cerebellum.
  
  
  CONCLUSIONS
  Clinical symptoms of the SVT are unspecific. In cases of an acute mastoiditis, neurological signs might be pathognomonic and can direct to a LST. Therapeutic concepts comprise intravenous antibiotics and operative elimination of disease. The exposition of the lateral sinus should be performed in any mastoidectomy for a LST in order to scrutinize its blood flow. In case of a thrombosis additional anticoagulative therapy might be indicated. To exclude a 2-staged brain abscess control MRI scans 7 through 14 days postoperatively are recommended.
authors.affiliation: Klinikum Nordstadt, Klinik für HNO-Heilkunde, regionale plastische Chirurgie, Kopf- und Halschirurgie, Hannover.
authors.forename: S K
authors.initials: SK
authors.lastname: Graß
authors.affiliation: Klinikum Nordstadt, Klinik für HNO-Heilkunde, regionale plastische Chirurgie, Kopf- und Halschirurgie, Hannover.
authors.forename: H-J
authors.initials: HJ
authors.lastname: Welkoborsky
authors.affiliation: Institut für Pathologie, Klinikum Nordstadt, Hannover.
authors.forename: C
authors.initials: C
authors.lastname: Bersch
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000368:Aged; D001922:Brain Abscess / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D002526:Cerebellar Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D018424:Cholesteatoma, Middle Ear / Q000150:complications* / Q000000981:diagnostic imaging* / Q000601:surgery; D005260:Female; D006801:Humans; D020227:Lateral Sinus Thrombosis / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008417:Mastoiditis / Q000150:complications* / Q000000981:diagnostic imaging* / Q000601:surgery; D008875:Middle Aged; D009460:Neurologic Examination; D010033:Otitis Media / Q000150:complications* / Q000000981:diagnostic imaging* / Q000601:surgery; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed