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When can lateral sinus thrombosis be treated conservatively?
Ahmet Kutluhan1, Muzaffer Kiriş, Veysel Yurttaş
1Department of Otorhinolaryngology, Yüzüncü Yil University, School of Medicine, Van, Turkey.
The Journal of Otolaryngology
|November 3, 2004
Summary
Lateral sinus thrombosis (LST) diagnosis relies on clinical and radiologic findings. Treatment for LST involves sinus exploration and obliteration if pus is present; otherwise, mastoidectomy suffices, with anticoagulants aiding non-obliterated sinuses.
Area of Science:
- Otolaryngology
- Neurology
- Radiology
Background:
- Lateral sinus thrombosis (LST) is a rare but serious complication of otitis media.
- Early diagnosis and appropriate treatment are crucial to prevent severe outcomes.
Purpose of the Study:
- To review clinical manifestations, radiologic findings, and treatment strategies for lateral sinus thrombosis (LST).
Main Methods:
- Retrospective review of patient records diagnosed with LST between 1995 and 2001.
- Analysis of clinical symptoms, imaging results (CT, MRA), and surgical interventions.
Main Results:
- Four LST cases were identified, with earache and headache being common symptoms.
- Computed tomography (CT) showed the 'delta sign' in three cases; magnetic resonance angiography (MRA) confirmed LST in one.
- Treatment varied: sinus exploration and obliteration for pus-positive cases, mastoidectomy for pus-negative cases. All received antibiotics and anticoagulants postoperatively.
Conclusions:
- Clinical presentation and advanced imaging are key for LST diagnosis.
- Surgical management should be tailored based on intraoperative findings (presence or absence of pus).
- Low-dose anticoagulation combined with antibiotics is beneficial for non-obliterated sinuses.