Pediatric otogenic lateral sinus thrombosis recanalization

Ryan E. Neilan, Brandon Isaacson, J. Walter Kutz, Kenneth H. Lee, Peter S. Roland

Research output: Contribution to journalArticlepeer-review

22 Scopus citations

Abstract

Objective: To describe the recovery outcomes in pediatric patients with otogenic lateral sinus and internal jugular vein thrombosis. Methods: An inpatient database from a tertiary care pediatric hospital was queried from 1999 to 2010 for the diagnosis code [325] thrombosis of intracranial venous sinus. Demographics, extent of thrombosis, surgical intervention, use of anticoagulation, and the presence of recanalization on follow-up imaging was collected. Results: Fifteen patients (10 male, 5 female) were identified with otogenic lateral sinus thrombosis. Eleven patients (73.3%) had evidence of thrombus in the transverse sinus, while 10 patients (66.7%) had thrombus in the internal jugular vein, and one patient (6.7%) had thrombus in the cavernous sinus. Five patients (33%) had otitic hydrocephalus. Twelve patients (80%) underwent operative manipulation of the lateral sinus including: three decompressions 20%, three needle aspirations 20%, and six venotomies with evacuation of clot or pus 40%. Twelve patients were anticoagulated with low molecular weight heparin, and three patients were not anticoagulated. Ten of fourteen patients (71.4%) who underwent follow-up magnetic resonance venography had evidence of partial (57.1%) or complete (14.3%) recanalization of the lateral sinus. All five patients with otitic hydrocephalus recovered as determined by a normal fundoscopic exam and recovery of abducens paresis. Conclusion: Recanalization of the lateral intracranial venous sinus occurred in the majority of the patients in this series. The role of operative intervention and/or anticoagulation remains unclear.

Original languageEnglish (US)
Pages (from-to)850-853
Number of pages4
JournalInternational Journal of Pediatric Otorhinolaryngology
Volume75
Issue number6
DOIs
StatePublished - Jun 2011

Keywords

  • Lateral sinus thrombosis
  • Otitic hydrocephalus
  • Otitis media

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Otorhinolaryngology

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