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Pediatric otogenic lateral sinus thrombosis recanalization
Ryan E Neilan1, Brandon Isaacson, J Walter Kutz
1Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, TX 75390-9035, USA.
International Journal of Pediatric Otorhinolaryngology
|April 26, 2011
Summary
Pediatric patients with otogenic lateral sinus thrombosis showed significant recanalization of the lateral intracranial venous sinus. Recovery outcomes were observed, though the roles of surgery and anticoagulation require further study.
Area of Science:
- Neurology
- Pediatric Otolaryngology
- Vascular Imaging
Background:
- Otogenic lateral sinus thrombosis is a rare but serious complication of middle ear infections in children.
- Internal jugular vein thrombosis can accompany lateral sinus thrombosis, potentially leading to increased intracranial pressure.
Purpose of the Study:
- To investigate the recovery outcomes in pediatric patients diagnosed with otogenic lateral sinus and internal jugular vein thrombosis.
- To analyze the extent of thrombosis, interventions, and recanalization rates.
Main Methods:
- A retrospective review of an inpatient database from 1999-2010 at a tertiary pediatric hospital.
- Inclusion criteria: diagnosis code for thrombosis of intracranial venous sinus.
- Data collected: demographics, thrombosis extent, surgical interventions, anticoagulation, and follow-up imaging for recanalization.
Main Results:
- Fifteen pediatric patients with otogenic lateral sinus thrombosis were identified.
- Thrombosis involved the transverse sinus (73.3%) and internal jugular vein (66.7%).
- Eighty percent underwent operative intervention; 80% received anticoagulation. Seventy-one percent showed recanalization on follow-up imaging. All five with otitic hydrocephalus recovered.
Conclusions:
- Recanalization of the lateral intracranial venous sinus is common in pediatric patients with otogenic thrombosis.
- The specific roles of operative intervention and anticoagulation in recovery remain uncertain and warrant further investigation.
