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Otogenic lateral sinus thrombosis in children.
D M Kaplan1, M Kraus, M Puterman
1Department of Otolaryngology and Head and Neck Surgery, Soroka Medical Center and Ben Gurion University of the Negev, Beer Sheva, Israel.
International Journal of Pediatric Otorhinolaryngology
|October 16, 1999
Summary
Lateral sinus thrombosis (LST) is a serious complication of ear infections, often presenting with overlapping symptoms that can mimic meningitis. Early diagnosis and treatment are crucial, with modern imaging aiding detection and mortality rates now below 10%.
Area of Science:
- Otolaryngology
- Pediatric Neurology
- Infectious Diseases
Background:
- Lateral sinus thrombosis (LST) presentation has evolved with antibiotic use.
- LST is now more common in adults with chronic ear disease than in children with acute otitis media.
Purpose of the Study:
- To review pediatric cases of lateral sinus thrombosis (LST).
- To analyze the causes, clinical presentation, and outcomes of LST in children.
Main Methods:
- Retrospective study of pediatric patients diagnosed with LST between 1982 and 1997.
- Review of medical records for diagnosis, treatment, and complications.
Main Results:
- Thirteen pediatric LST cases were identified, with causes including acute and chronic otitis media.
- Common symptoms were headache, fever, aural discharge, and mastoid tenderness; four patients were initially misdiagnosed with meningitis.
- Intracranial complications like perisinus and brain abscesses were frequent; one patient died, while others recovered.
Conclusions:
- LST diagnosis can be challenging due to prior antibiotic use and overlapping symptoms with meningitis.
- A high index of clinical suspicion is essential, even with advanced imaging.
- Mortality for LST has significantly decreased, now reported below 10%.