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Paediatric Otogenic Cerebral Venous Thrombosis: Diagnostic Approach and Therapeutic Management - A Five-Year

Maria Wolniewicz1, Lidia Zawadzka-Głos1

  • 1Department of Pediatric Otolaryngology, Medical University of Warsaw, Poland.

Otolaryngologia Polska = the Polish Otolaryngology
|January 20, 2025
PubMed

Insights

This study found anticoagulation therapy effective and safe for pediatric central venous thrombosis (CVT) linked to ear infections. Further multicenter research is needed for evidence-based guidelines.

Area of Science:

  • Pediatric Otolaryngology
  • Infectious Diseases
  • Hematology

Background:

  • Central venous thrombosis (CVT) is a known complication of acute otitis media (AOM) and acute mastoiditis (AM).
  • Despite antibiotic use, pediatric thrombotic complications are increasing, sometimes without typical neurological signs.
  • The potential link between COVID-19 and rising CVT incidence requires investigation.

Purpose of the Study:

  • To explore the correlation between COVID-19 and pediatric otogenic CVT.
  • To share therapeutic experiences due to a lack of standardized treatment protocols.
  • To analyze treatment outcomes and safety of anticoagulation in pediatric otogenic CVT.

Main Methods:

  • Retrospective observational analysis of pediatric patients with otogenic CVT (2018-2024).
  • Evaluation of thrombotic extent, complications, and anticoagulation strategies (monotherapy vs. combination).
  • Assessment of therapeutic monitoring and outcomes, including recanalization rates.

Main Results:

  • 13 patients included; 11 with complete follow-up.
  • Low-molecular-weight heparin (LMWH) monotherapy achieved 60% complete recanalization.
  • Combination anticoagulation showed a 16.67% success rate; all cases had thrombosis regression.

Conclusions:

  • Anticoagulation therapy is effective and safe for pediatric otogenic CVT.
  • No significant hemorrhagic complications were observed during treatment.
  • Multicenter studies are essential to develop evidence-based clinical guidelines for otogenic CVT.

Keywords:
acute mastoiditisacute otitis mediaanticoagulation therapycentral venous thrombosispediatric otolaryngology

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