Management of otogenic lateral sinus thrombosis

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.…”

“…Both of our cases had a history of protracted CSOM with abuse of antibiotics. The medical literature cites antibiotic resistance as an important cause for aetiopathogenesis of SLST [ 2 ]. Further, both the cases had an actively discharging ear at the time of diagnosis of this complication, thereby implying that “Acute Suppurative Otitis Media (ASOM)” is an important predisposing factor.…”

“…Further, both the cases had an actively discharging ear at the time of diagnosis of this complication, thereby implying that “Acute Suppurative Otitis Media (ASOM)” is an important predisposing factor. Several studies have also delineated the role of ASOM in causing intracranial complications [ 2 ]. Both cases had an atypical clinical presentation and were diagnosed on CT scan.…”

“…However, early diagnosis and use of potent antibiotics have markedly decreased the mortality to less than 5% [ 1 ]. In this context, it would be important to note that the clinical presentation of SLST has become more subtle with the advent of potent and new antibiotics [ 1 , 2 ]. The complication no longer presents with classical clinical features mentioned in the medical text, severe wasting illness with “Picket Fence” fever.…”

“…Some suggest incision of the sinus with evacuation of the clot, while others have adopted a more conservative approach: needle aspiration of the sinus. There is also no consensus among otologists on the role of anticoagulants and ligation of internal jugular vein [ 2 , 3 ]. Recent review of literature mentions the management of SLST with no sinus exploration [ 1 – 3 ].…”