Aim

We aimed to describe otogenic lateral sinovenous thrombosis (OLST), a rare, potentially life-threatening complication of otomastoiditis.

Methods

Children diagnosed with OLST in a tertiary-care Hospital from 2014 to 2019 was retrospectively selected. Clinical and radiological features, timing of diagnosis, treatment and outcome are reported.

Results

Seven children (5 males) were studied. Fever and neurological symptoms (headache, lethargy, diplopia, dizziness and papilledema) were always present. Otalgia and/or otorrhea were found in 6 children; none had signs of mastoiditis. Diagnosis was reached after 7 days (median) from clinical onset. Brain CT-scan was performed in 5 children being diagnostic for 3. Venography-MRI detected OLST and mastoiditis in all cases without parenchymal lesions. Treatment was based on intravenous rehydration, antibiotic and low-molecular weight heparin; acetazolamide was added in 3 children. Mastoidectomy and ventriculoperitoneal-shunting were selectively performed. Patients were discharged after 26 days (median). Follow-up neuroimaging showed sinus recanalization after a median time of 6 months.

Conclusion

A multidisciplinary approach is needed to optimize diagnostic-therapeutic protocols of pediatric OLST.

中文翻译：

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儿童耳源性侧静脉静脉血栓形成：单中心病例报道和叙述性回顾。

目标

我们旨在描述耳源性侧窦静脉血栓形成（OLST），这是一种罕见的，可能危及生命的子宫肌瘤炎并发症。

方法

回顾性选择2014年至2019年在三级医院诊断为OLST的儿童。报告了临床和放射学特征，诊断时机，治疗和结果。

结果

研究了七个孩子（五名男性）。经常出现发烧和神经系统症状（头痛，嗜睡，复视，头晕和乳头水肿）。在6名儿童中发现了眼痛和/或耳漏；没有人有乳突炎的迹象。从临床发作开始的7天（中值）后就达到了诊断。在5例诊断为3例的儿童中进行了脑CT扫描。在所有无实质性病变的病例中，静脉造影MRI检测到OLST和乳突炎。治疗以静脉补液，抗生素和低分子量肝素为基础。在3名儿童中添加了乙酰唑胺。选择性行乳突切除术和心室腹膜分流术。患者在26天后（中值）出院。中位时间为6个月后，随访神经影像检查显示窦性再通。

结论

需要一种多学科方法来优化儿科OLST的诊断治疗方案。