Otogenic Cerebral Sinus Thrombosis in Children: A Narrative Review

Cerebral venous thrombosis (CVT) is a rare entity that remains a diagnostic challenge due to various clinical manifestations and a wide variety of causative agents. Local infections, such as acute (AOM) or chronic otitis media, can play a role in the pathogenesis of CVT. The proximity of the tympanic cavity and temporal bone air cells to the dural venous sinuses predisposes them to secondary thrombosis. The release of inflammatory cytokines and activation of the coagulation pathway in the middle ear space in response to infection may trigger the thrombotic mechanism in venous sinuses of the central nervous system. There is no consensus in the literature concerning the treatment of otogenic cerebral venous sinus thrombosis (CVST). Both the extent of the surgery and the use of anticoagulants are disputable. The aim of the study was to provide a thorough analysis of the literature concerning CVST in patients with AOM and acute mastoiditis (AM). The current surgical and conventional treatment strategies are presented. Special attention has been attached to the predisposing factors, the extent of the surgery, and the role of anticoagulants in the treatment of septic otogenic CVST.

Automated summary

Cerebral venous thrombosis (CVT) is a rare condition with diverse clinical presentations and causes, including local infections such as acute or chronic otitis media. The proximity of the middle ear to the dural venous sinuses can lead to secondary thrombosis. Inflammatory responses and coagulation activation triggered by infection may contribute to the development of venous sinus thrombosis in the central nervous system. Treatment options for otogenic cerebral venous sinus thrombosis are still debated, including the extent of surgery and use of anticoagulants. This study provides a comprehensive analysis of the literature on CVST in patients with AOM and AM, discussing current treatment strategies and emphasizing predisposing factors, surgical approaches, and the role of anticoagulants.