title: Otogenic lateral sinus thrombosis in children: A review of 7 cases.
abstract: Otogenic lateral sinus thrombosis (LST) is a rare but serious intracranial complication of acute or chronic otitis media. Reported mortality rates have ranged from 8 to 25%; the pediatric mortality rate might be as low as 5%. Controversy still exists over the medical and surgical management of this condition. We conducted a retrospective chart review of 7 cases of pediatric otogenic LST that were treated at our institution over a period of 8 years. We hypothesized that good outcomes in very sick patients can be achieved by aggressively managing the mastoid cavity and without the need for a thrombectomy. Our study group was made up of 4 boys and 3 girls, aged 6 to 15 years (mean: 11.1). All patients received intravenous antibiotics and underwent mastoidectomy with unroofing of the sigmoid sinus and placement of a tympanostomy tube. Sinus exploration with thrombectomy was not performed in any patient. Anticoagulation was used perioperatively in 5 patients (71%) without complication. All patients recovered well without major sequelae, which supports our hypothesis. We also describe the case of a patient with multiple concomitant intracranial comorbidities associated with this rare condition.
authors.affiliation: Department of Otolaryngology and Communication Sciences, Upstate University Hospital, Campus West Bldg., 750 E. Adams St., Room 241, Syracuse, NY 13210, USA. ryanje@upstate.edu.
authors.forename: Jesse T
authors.initials: JT
authors.lastname: Ryan
authors.forename: Maria
authors.initials: M
authors.lastname: Pena
authors.forename: George H
authors.initials: GH
authors.lastname: Zalzal
authors.forename: Diego A
authors.initials: DA
authors.lastname: Preciado
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use; D002648:Child; D005260:Female; D006801:Humans; D020227:Lateral Sinus Thrombosis / Q000209:etiology / Q000628:therapy*; D008297:Male; D008416:Mastoid / Q000601:surgery*; D008417:Mastoiditis / Q000150:complications*; D008876:Middle Ear Ventilation; D010033:Otitis Media / Q000150:complications*; D012189:Retrospective Studies
chemical_list: D000900:Anti-Bacterial Agents; D000925:Anticoagulants