Lateral sinus thrombosis in children: Case series

Lateral sinus thrombosis is rare but potentially fatal condition. The consequences of misdiagnosis of this condition are detrimental. Aims: To review our experience in lateral sinus thrombosis secondary to otogenic disease in pediatric population. Settings and Design: Retrospective study of case series treated in two teaching hospitals over five years. Materials and Methods: Clinically and radiologically diagnosed cases of lateral sinus thrombosis were identified through database search. Results: Lateral sinus thrombosis was the result of chronic suppurative otitis media in 7 cases, with 3 patients (42.85%) having cholesteatoma. There were no associated intracranial complications in any of the patients. Two patients (28.57%) underwent medical treatment, and 5 patients (71.43%) had surgical treatment. Aggressive and early surgical intervention treatment was initiated according to evaluation of preoperative findings. The sigmoid sinus was aspirated in three patients. Complete re-canalization or lysis of the thrombus was achieved. Anticoagulant agent was used in 1 patient (14.28%). Six patients (85.82%) presented with the typical lateral sinus thrombosis clinical features, and 1 patient (14.28%) presented with otorrhea solely. Mastoidectomy was undertaken in 5 patients (71.42%) with canal wall up in 2 patients (28.57%) and canal wall down in 2 patients (28.57%). Myringotomy, ventilation tube insertion, and cortical mastoidectomy were done in 1 patient (14.28%). Conclusions: Early and aggressive surgical intervention of lateral sinus thrombosis otogenic complication can minimize mortality, hospitalization period, and length of medical treatment. High index of suspicion is important