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Pediatric otogenic sigmoid sinus thrombosis: 12-Year experience
David Ulanovski1, Joanne Yacobovich2, Liora Kornreich3
1Pediatric Ear-Nose-Throat Unit, Schneider Children's Medical Center of Israel, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Schneider Children's Medical Center of Israel, Tel Aviv, Israel.
International Journal of Pediatric Otorhinolaryngology
|April 17, 2014
Summary
Conservative surgery and anticoagulation are effective treatments for pediatric otogenic sigmoid sinus thrombosis, a rare complication of acute otitis media. Most children experienced sinus recanalization with no long-term complications.
Area of Science:
- Otolaryngology
- Pediatric Neurosurgery
- Infectious Diseases
Background:
- Otogenic sigmoid sinus thrombosis (SST) is a rare but serious complication of acute otitis media in children.
- Treatment strategies, particularly surgical intervention, remain debated.
Purpose of the Study:
- To review the 12-year experience of a major medical center in treating pediatric sigmoid sinus thrombosis.
- To evaluate the efficacy and safety of different treatment modalities.
Main Methods:
- Retrospective case series of 24 children (aged 7-155 months) treated for SST from 2000-2011.
- All patients received broad-spectrum antibiotics and ventilation tube insertion.
- Most patients underwent mastoidectomy with sigmoid sinus bone decompression; 22 received low-molecular-weight heparin.
Main Results:
- Acute otitis media with mastoiditis was the cause in all cases; 21 had subperiosteal abscess.
- Mastoidectomy without sinus aspiration/drainage was performed in 87.5%.
- 87% of children showed sinus recanalization on follow-up imaging; no neurologic sequelae were observed.
Conclusions:
- Conservative surgical intervention (mastoidectomy with decompression) is effective for pediatric otogenic SST.
- Low-molecular-weight heparin is safe and may prevent thrombus extension.
- Prompt treatment leads to favorable outcomes with high rates of sinus recanalization.
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