Otogenic Lateral Sinus Thrombosis in Children

Objective: To present the results and experience with diagnosis and treatment of lateral sinus thrombosis, as a complication of otitis media, in a pediatric population. Patients: Five children, 2 girls and 3 boys, with age ranging from 3 to 9 years, identified as having otogenic lateral sinus thrombosis confirmed with clinical symptoms and radiologic findings. Intervention: All patients underwent canal wall intact mastoidectomy with tympanostomic tube insertion. In all patients, granulation tissues from mastoids were removed and exploration of the lateral sinuses by needle aspiration was performed. All patients were treated with broad-spectrum antibiotics, and 4 of 5 patients were administered anticoagulants. Main Outcome Measures: Clinical improvement, resolution of symptoms. Results: Patients with a diagnosis of otogenic lateral sinus thrombosis commonly presented with headache, nausea, and vomiting. Three patients had a bulging drum, 1 had otorrhea, and 1 had only retraction pocket. After surgery and pharmacologic treatment, clinical improvement was observed in all patients. Complication after anticoagulant administration was not observed. All patients were followed up from 12 to 36 months. All patients showed partial or complete recanalization on repeat imaging. Conclusion: Lateral sinus thrombosis is a rare complication of otitis media. In some cases, diagnosis is delayed because neurologic, rather than otologic, symptoms may dominate the presentation of the lateral sinus thrombosis. In our observation, the prognosis of lateral sinus thrombosis is better when surgical and pharmacologic treatments are instituted early.