Internal Jugular Vein Thrombosis Associated with Acute Mastoiditis in a Pediatric Age

Abstract

Internal jugular vein thrombosis may be a complication of acute otitis media, without involvement of the sigmoid sinus and with a starting point in the jugular bulb. Anticoagulation associated with antibiotic therapy can be considered a safe and effective treatment. Surgery should only be performed to eliminate the source of infection from the middle ear and mastoid.

Septic Lateral Sinus Thrombosis: Sinus Exploration Is Unnecessary

“…Both cases had an atypical clinical presentation and were diagnosed on CT scan. Although literature is replete with references that suggest “hypercoagulability” as an important predisposing factor for OLST [ 2 , 4 ], no “hypercoagulability” state was detected in any of our patients.…”

“…The venous occlusion resolves by 4 to 6 weeks with adequate antibiotic treatment only (no adjuvant surgery or anticoagulant therapy is required). Thus, once the source of infection is eradicated, the thrombus resolves [ 3 , 4 , 7 ]. However, it would be pertinent to note that the definitive treatment for CSOM-cholesteatoma disease is surgery [ 1 , 2 ].…”

“…Also interestingly, there are also sporadic reports of management of SLST with antibiotics and anticoagulant therapy alone with no mastoid surgery at all in cases of CSOM-mucosal disease, especially in children [ 6 , 11 ]. It would however be pertinent to note that the role of anticoagulants is contested [ 2 – 4 ]. A recent report by Shah et al highlights the potential complications of anticoagulation therapy in children suffering from lateral sinus thrombosis [ 12 ].…”

Pediatric otogenic lateral sinus thrombosis: Role of anticoagulation and surgery

“…Articles were excluded because no follow up imaging (n = 6), chronic otitis media with cholesteatoma (n = 2), lack of distinction of patients receiving anticoagulation (n = 1), non otogenic (n = 1), adult (n = 1), no involvement of sigmoid sinus (n = 2). Leaving 5 articles [3][4][5][6][7] and 19 patients for further data extraction and inclusion with our data (see Fig. 3).…”

Low molecular weight heparin therapy in pediatric otogenic sigmoid sinus thrombosis: A safe treatment option?

“…Surgical treatment options include simple mastoidectomy, thrombectomy and ligation of the internal jugular vein [1,5,6,[9][10][11][12][13]. Only few studies have investigated the role of anticoagulants in the treatment of otogenic LST.…”