Bilateral acute mastoiditis complicated by lateral sinus thrombosis

Abstract

A case of bilateral mastoiditis with subperiosteal abscesses complicating acute otitis media in a two and a half year old girl is presented. Contrast enhanced computerized tomography confirmed the diagnosis of right lateral sinus thrombosis. The aetiology, diagnosis and management of these conditions are discussed.

Bilateral acute mastoiditis and subperiosteal abscesses in a child managed by simultaneous bilateral mastoid surgery

“…1,2 Bilateral acute mastoiditis associated with bilateral subperiosteal abscesses is extremely rare, with only one previous report. 3 This report documents bilateral acute mastoiditis associated with bilateral subperiosteal abscesses in a young child. A short video, available on The Journal of Laryngology & Otology website, demonstrates the key stages of the operation (Appendix 1).…”

Lateral sinus thrombosis

“…Although antibiotics have generally reduced the incidence of lateral sinus thrombosis, they have not reduced the mortality rate 5,8 . In the era of antibiotics, the presentation of lateral sinus thrombosis has changed from pronounced signs and symptoms to vague and non-specific symptoms.…”

“…Recent authors are of the opinion that with modern antibiotic therapy internal jugular vein ligation is not required 6 . Internal jugular vein ligation should be reserved for those cases in which septicemia and embolisation do not respond to initial surgery and antibiotic treatment 7,8,10,11 . The presence of lateral sinus thrombosis mandates further investigation for additional intra cranial complication.…”

Nonseptic and Septic Lateral Sinus Thrombosis: A Review

“…Internal jugular vein ligation should reserved for those cases in which septicemia and embolisation which do not respond to initial surgery and antibiotic treatment [37,38].…”

“…However, they are rarely used now because most infections can be controlled with antibiotics and surgery, and this tends to prevent the thrombus from propagating. Anticoagulants arrest the spread of thrombosis but may increase the risk of venous infarctions and are therefore no longer used [17,37,38]. Their use has been reserved by some authors for cases in which the thrombus spreads proximally to the internal jugular vein or retrogradely to the more distal intracranial sinuses [15,32,39,40].…”